Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00444 | Date 14/08/2018 |
| Token No | SM/18-19/508 14/08/2018 | Serial | 022 |
| Patient Name | Mr. PULAK PAL | Contact No | |
| Address | Age | 50 Male | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 58 KG |
| Pulse Rate | 64 / min | Height | cm |
| Diagnosis | |||