Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00180 | Date 18/08/2018 |
| Token No | SM/18-19/189 18/08/2018 | Serial | 025 |
| Patient Name | Mr. JAYNTA DAS | Contact No | |
| Address | Age | 30 Male | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 70 KG |
| Pulse Rate | 74 / min | Height | cm |
| Diagnosis | |||