Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 02121 | Date 27/05/2019 |
| Token No | SM/18-19/3817 27/05/2019 | Serial | 020 |
| Patient Name | Mrs. SUMAN RAJBHAR | Contact No | NOT GIVEN |
| Address | L B S ROAD | Age | 30 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||