Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02526 | Date 22/07/2019 |
| Token No | SM/18-19/4912 22/07/2019 | Serial | 005 |
| Patient Name | Mrs. PIYALI DHARA | Contact No | NOT GIVEN |
| Address | KENAS LANE | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/60 mmHg | Weight | KG |
| Pulse Rate | 70 / min | Height | cm |
| Diagnosis | |||