Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01782 | Date 10/03/2019 |
| Token No | SM/18-19/2784 10/03/2019 | Serial | 026 |
| Patient Name | Mr. RUPNARAYAN RAJBHAR | Contact No | 7278280240 |
| Address | 10 DEY STreet | Age | 63 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||