Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00418 | Date 30/08/2018 |
| Token No | SM/18-19/833 04/09/2018 | Serial | 008 |
| Patient Name | Mr. SANJAY DAS | Contact No | |
| Address | BSNL DRIVER | Age | 28 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||