Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00404 | Date 30/08/2018 |
| Token No | SM/18-19/459 30/08/2018 | Serial | 005 |
| Patient Name | Mr. SAROJ JANA | Contact No | |
| Address | Age | 47 Male | |
| Token For | Medicine, | Charge | Free |
| B.P | 140/90 mmHg | Weight | KG |
| Pulse Rate | 86 / min | Height | cm |
| Diagnosis | |||