Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00123 | Date 07/08/2018 |
| Token No | SM/18-19/827 04/09/2018 | Serial | 002 |
| Patient Name | Mr. BIBHUTI NAG | Contact No | |
| Address | RISHI BANKIM SARANI | Age | 54 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 130/88 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||