Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01083 | Date 13/09/2018 |
| Token No | SM/18-19/1409 13/09/2018 | Serial | 003 |
| Patient Name | Mr. SUKUMAR SAMANTA | Contact No | |
| Address | Age | 38 Male | |
| Token For | Medicine, | Charge | Free |
| B.P | 170/90 mmHg | Weight | 82 KG |
| Pulse Rate | 94 / min | Height | cm |
| Diagnosis | |||