Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 01032 | Date 28/09/2018 |
| Token No | SM/18-19/1340 28/09/2018 | Serial | 030 |
| Patient Name | Mr. KAILAS HELA | Contact No | |
| Address | 552 GT ROAD | Age | 56 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 128/80 mmHg | Weight | 68 KG |
| Pulse Rate | 78 / min | Height | cm |
| Diagnosis | |||