Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04691 | Date 09/08/2021 |
| Token No | SM/21-22/783 09/08/2021 | Serial | 002 |
| Patient Name | Mr. UDAY RAJBHAR | Contact No | 9748377653 |
| Address | 17 PAL BAGAN | Age | 14 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||