Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00679 | Date 13/09/2018 |
| Token No | SM/18-19/915 13/09/2018 | Serial | 004 |
| Patient Name | Mrs. SHILA DEBI | Contact No | NOT GIVEN |
| Address | BANERJEE PARA | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 75 KG |
| Pulse Rate | 76 / min | Height | cm |
| Diagnosis | |||