Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03988 | Date 14/07/2020 |
| Token No | SM/19-20/8815 14/07/2020 | Serial | 013 |
| Patient Name | Miss MISTI RAJBHAR | Contact No | 8444904288 |
| Address | DEY STREET | Age | 8 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||