Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00755 | Date 20/09/2018 |
| Token No | SM/18-19/1017 20/09/2018 | Serial | 017 |
| Patient Name | Mr. SOMNATH DEY | Contact No | |
| Address | A.B GARDEN LANE | Age | 56 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 136/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||