Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04491 | Date 14/06/2021 |
| Token No | SM/21-22/424 14/06/2021 | Serial | 022 |
| Patient Name | Mr. SAMAR BARAL | Contact No | 7686951022 |
| Address | 71 E PATUA PARA LANE | Age | 60 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||