Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00641 | Date 05/09/2018 |
| Token No | SM/18-19/809 05/09/2018 | Serial | 002 |
| Patient Name | Mr. RAM ROCHAN RAUT | Contact No | |
| Address | Age | 41 Male | |
| Token For | Medicine, | Charge | Free |
| B.P | 128/74 mmHg | Weight | KG |
| Pulse Rate | 69 / min | Height | cm |
| Diagnosis | |||