Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02753 | Date 07/08/2019 |
| Token No | SM/18-19/5486 07/08/2019 | Serial | 002 |
| Patient Name | Mr. SUBHAM RAJBHAR | Contact No | 9007591910 |
| Address | 79 DEY STREET | Age | 15 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||