Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00663 | Date 11/09/2018 |
| Token No | SM/18-19/870 11/09/2018 | Serial | 001 |
| Patient Name | Mr. FARUK ALI | Contact No | |
| Address | CHAMPA ROAD, RISHRA | Age | 74 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 152/88 mmHg | Weight | 59 KG |
| Pulse Rate | 90 / min | Height | cm |
| Diagnosis | |||