Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00658 | Date 11/09/2018 |
| Token No | SM/18-19/859 11/09/2018 | Serial | 014 |
| Patient Name | Miss RASHMITA SAMON | Contact No | 9339830034 |
| Address | 21 CHOWDHURI PARA LANE | Age | 23 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 116/74 mmHg | Weight | 46 KG |
| Pulse Rate | 100 / min | Height | cm |
| Diagnosis | |||