Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00630 | Date 06/09/2018 |
| Token No | SM/18-19/772 06/09/2018 | Serial | 010 |
| Patient Name | Mr. AZAD ALI | Contact No | |
| Address | DEY STREET | Age | 50 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | KG |
| Pulse Rate | 68 / min | Height | cm |
| Diagnosis | |||