Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03395 | Date 15/11/2019 |
| Token No | SM/18-19/7434 15/11/2019 | Serial | 033 |
| Patient Name | Mrs. GOURI ADHIKARI | Contact No | 9330725824 |
| Address | 24 THAKUR BATI STREET | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||