Ticket for Outdoor Patient
| Ward No. | U-PHC No. | Registration No. 00091 | Date 06/08/2018 |
| Token No | SM/18-19/94 06/08/2018 | Serial | 021 |
| Patient Name | Mr. KAILASH HELA | Contact No | |
| Address | PALBAGAN | Age | 56 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 110/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||