Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01522 | Date 22/12/2018 |
| Token No | SM/18-19/2147 22/12/2018 | Serial | 024 |
| Patient Name | Mr. SOUMEN PAKIRA | Contact No | NOT GIVEN |
| Address | Age | 31 Male | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/70 mmHg | Weight | 57 KG |
| Pulse Rate | 72 / min | Height | cm |
| Diagnosis | |||