Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04706 | Date 11/08/2021 |
| Token No | SM/21-22/812 11/08/2021 | Serial | 010 |
| Patient Name | Mr. SANTOSH THANDAR | Contact No | 8101205417 |
| Address | PATUA PARA | Age | 31 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||