Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 01584 | Date 17/01/2019 |
| Token No | SM/18-19/2313 22/01/2019 | Serial | 009 |
| Patient Name | Mr. BULU SHA | Contact No | 9748153381 |
| Address | 23 TIN BAZAR | Age | 53 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||