Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00945 | Date 24/09/2018 |
| Token No | SM/18-19/1226 24/09/2018 | Serial | 005 |
| Patient Name | Mr. ROHAN SHA | Contact No | NOT GIVEN |
| Address | PAL BAGAN | Age | 45 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 138/76 mmHg | Weight | KG |
| Pulse Rate | 68 / min | Height | cm |
| Diagnosis | |||