Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00423 | Date 30/08/2018 |
| Token No | SM/18-19/846 11/09/2018 | Serial | 001 |
| Patient Name | Mr. GANESH BARIK | Contact No | |
| Address | 9, INDIA JUTE MILL | Age | 70 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 160/80 mmHg | Weight | 43 KG |
| Pulse Rate | 100 / min | Height | cm |
| Diagnosis | |||