Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03425 | Date 19/11/2019 |
| Token No | SM/18-19/7506 19/11/2019 | Serial | 003 |
| Patient Name | Mr. GANESH RAJBHAR | Contact No | 9748377653 |
| Address | 17 PAL BAGAN | Age | 41 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 80 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||