Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01369 | Date 14/12/2018 |
| Token No | SM/21-22/755 03/08/2021 | Serial | 015 |
| Patient Name | Mr. BIRENDRA PRASAD | Contact No | 8274941168 |
| Address | 19 DASTI LANE | Age | 41 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||