Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 03156 | Date 01/10/2019 |
| Token No | SM/18-19/6831 01/10/2019 | Serial | 021 |
| Patient Name | Mr. SISSAM ADHIKARY | Contact No | 9062869507 |
| Address | 9/B PATUA PARA LANE | Age | 29 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||