Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00624 | Date 05/09/2018 |
| Token No | SM/18-19/762 05/09/2018 | Serial | 001 |
| Patient Name | Mr. FALGUNI DAS | Contact No | |
| Address | JANNAGAR ROAD | Age | 37 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/80 mmHg | Weight | 52 KG |
| Pulse Rate | 58 / min | Height | cm |
| Diagnosis | |||