Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00650 | Date 04/09/2018 |
| Token No | SM/18-19/838 04/09/2018 | Serial | 013 |
| Patient Name | Mrs. JAMUNA PAL | Contact No | |
| Address | INDIAN JUTE MILL | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||