Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02780 | Date 09/08/2019 |
| Token No | SM/21-22/2126 10/02/2022 | Serial | 006 |
| Patient Name | Miss KIRAN RAJBHAR | Contact No | 7044146231 |
| Address | 10 DEY STREET | Age | 9 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||