Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00130 | Date 08/08/2018 |
| Token No | SM/18-19/135 08/08/2018 | Serial | 001 |
| Patient Name | Mrs. SUMITRA DAS | Contact No | 26527028 |
| Address | 3/C GHOSH PARA LANE | Age | 48 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 170/80 mmHg | Weight | KG |
| Pulse Rate | 104 / min | Height | cm |
| Diagnosis | |||