Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00018 | Date 02/08/2018 |
| Token No | SM/18-19/18 02/08/2018 | Serial | 017 |
| Patient Name | Mr. BINOD KUMAR DAS | Contact No | |
| Address | 573 G.T.ROAD | Age | 51 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 100/60 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||