Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01055 | Date 05/10/2018 |
| Token No | SM/18-19/1378 05/10/2018 | Serial | 019 |
| Patient Name | Mr. KOUSHIK DAS | Contact No | |
| Address | DEY STREET | Age | 30 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 62 KG |
| Pulse Rate | 74 / min | Height | cm |
| Diagnosis | |||