Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00822 | Date 15/09/2018 |
| Token No | SM/18-19/1084 15/09/2018 | Serial | 004 |
| Patient Name | Mr. INDRAJIT DEY | Contact No | |
| Address | PAL BAGAN | Age | 34 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/86 mmHg | Weight | 62 KG |
| Pulse Rate | 92 / min | Height | cm |
| Diagnosis | |||