Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00113 | Date 07/08/2018 |
| Token No | SM/18-19/904 11/09/2018 | Serial | 035 |
| Patient Name | Mr. JAYANTA SADHUKHAN | Contact No | |
| Address | Age | 50 Male | |
| Token For | Medicine, | Charge | Free |
| B.P | 152/78 mmHg | Weight | KG |
| Pulse Rate | 82 / min | Height | cm |
| Diagnosis | |||