Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00516 | Date 20/08/2018 |
| Token No | SM/18-19/896 11/09/2018 | Serial | 027 |
| Patient Name | Mr. KESTO DAS | Contact No | |
| Address | PANCHANAN TALA LANE | Age | 40 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 120/78 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||