Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00969 | Date 25/09/2018 |
| Token No | SM/18-19/1256 25/09/2018 | Serial | 018 |
| Patient Name | Mr. RANJIT DAS | Contact No | NOT GIVEN |
| Address | DEY STREET | Age | 54 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 130/88 mmHg | Weight | 62 KG |
| Pulse Rate | 74 / min | Height | cm |
| Diagnosis | |||