Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 01028 | Date 28/09/2018 |
| Token No | SM/18-19/1334 28/09/2018 | Serial | 024 |
| Patient Name | Mrs. SIPRA MONDAL | Contact No | NOT GIVEN |
| Address | 552 GT ROAD | Age | 43 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/70 mmHg | Weight | 54 KG |
| Pulse Rate | 75 / min | Height | cm |
| Diagnosis | |||