Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05482 | Date 03/03/2022 |
| Token No | SM/21-22/2296 03/03/2022 | Serial | 002 |
| Patient Name | Mr. KRISHNA KUMAR RAJBHAR | Contact No | 7003804132 |
| Address | 10 DEY STREET | Age | 29 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||