Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00215 | Date 25/08/2018 |
| Token No | SM/18-19/231 25/08/2018 | Serial | 001 |
| Patient Name | Mr. SOHAM APOT | Contact No | |
| Address | DEYSTREET | Age | 26 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | KG |
| Pulse Rate | 74 / min | Height | cm |
| Diagnosis | |||