Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00675 | Date 11/09/2018 |
| Token No | SM/18-19/909 11/09/2018 | Serial | 040 |
| Patient Name | Mr. SANDIP DAS | Contact No | |
| Address | 1 NO A B GARDEN LANE | Age | 26 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||