Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00360 | Date 13/08/2018 |
| Token No | SM/18-19/404 13/08/2018 | Serial | 011 |
| Patient Name | Mr. BHOLA NATH CHAKRABORTY | Contact No | |
| Address | Age | 71 Male | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/60 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||