Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00317 | Date 28/08/2018 |
| Token No | SM/18-19/808 05/09/2018 | Serial | 001 |
| Patient Name | Mr. SAIKAT MODAK | Contact No | |
| Address | Age | 26 Male | |
| Token For | Medicine, | Charge | Free |
| B.P | 130/88 mmHg | Weight | KG |
| Pulse Rate | 74 / min | Height | cm |
| Diagnosis | |||