Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00644 | Date 05/09/2018 |
| Token No | SM/18-19/823 05/09/2018 | Serial | 016 |
| Patient Name | Mr. SEKH AMIN | Contact No | |
| Address | JOLKOL WORKER | Age | 35 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | KG |
| Pulse Rate | 64 / min | Height | cm |
| Diagnosis | |||