Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01380 | Date 18/12/2018 |
| Token No | SM/18-19/1986 18/12/2018 | Serial | 012 |
| Patient Name | Master KOKHON ALI | Contact No | |
| Address | DEY STREET | Age | 13 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | 90 / min | Height | cm |
| Diagnosis | |||