Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01490 | Date 20/12/2018 |
| Token No | SM/18-19/2108 20/12/2018 | Serial | 056 |
| Patient Name | Mr. AMAL DEY | Contact No | NOT GIVEN |
| Address | Age | 24 Male | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 57 KG |
| Pulse Rate | 74 / min | Height | cm |
| Diagnosis | |||