Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01464 | Date 20/12/2018 |
| Token No | SM/18-19/2082 20/12/2018 | Serial | 030 |
| Patient Name | Mr. RAJESH ROUTRAY | Contact No | NOT GIVEN |
| Address | Age | 36 Male | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 70 KG |
| Pulse Rate | 74 / min | Height | cm |
| Diagnosis | |||