Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01029 | Date 28/09/2018 |
| Token No | SM/18-19/1335 28/09/2018 | Serial | 025 |
| Patient Name | Miss PUSPA KHATUN | Contact No | 9633874512 |
| Address | RAM SITA LANE | Age | 20 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 52 KG |
| Pulse Rate | 74 / min | Height | cm |
| Diagnosis | |||