Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00865 | Date 12/09/2018 |
| Token No | SM/18-19/1137 12/09/2018 | Serial | 027 |
| Patient Name | Mr. TARAPADA DOLUI | Contact No | |
| Address | DEY STREET | Age | 64 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/92 mmHg | Weight | 63 KG |
| Pulse Rate | 84 / min | Height | cm |
| Diagnosis | |||