Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00103 | Date 07/08/2018 |
| Token No | SM/18-19/107 07/08/2018 | Serial | 003 |
| Patient Name | Mr. JITENDRA NATH LAHIRI | Contact No | |
| Address | CHATTERJEE LANE | Age | 56 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | KG |
| Pulse Rate | 85 / min | Height | cm |
| Diagnosis | |||