Ticket for Outdoor Patient
| Ward No. | U-PHC No. | Registration No. 00057 | Date 04/08/2018 |
| Token No | SM/18-19/57 04/08/2018 | Serial | 008 |
| Patient Name | Mrs. MUMTAZ BEGUM | Contact No | |
| Address | Age | 50 Female | |
| Token For | Medicine, | Charge | Free |
| B.P | 100/60 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||