Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01030 | Date 28/09/2018 |
| Token No | SM/18-19/1336 28/09/2018 | Serial | 026 |
| Patient Name | Mrs. HASINA BEGUM | Contact No | NOT GIVEN |
| Address | RAMSITA LANE | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 138/92 mmHg | Weight | 74 KG |
| Pulse Rate | 84 / min | Height | cm |
| Diagnosis | |||