Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00794 | Date 22/09/2018 |
| Token No | SM/18-19/1056 22/09/2018 | Serial | 036 |
| Patient Name | Mr. JAYNAL SK | Contact No | 9748562130 |
| Address | DEY STREET | Age | 43 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 128/82 mmHg | Weight | 60 KG |
| Pulse Rate | 84 / min | Height | cm |
| Diagnosis | |||