Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09877 | Date 04/08/2023 |
| Token No | SM/22-23/11397 04/08/2023 | Serial | 025 |
| Patient Name | Mr. MADAN GIRI | Contact No | 7720820319 |
| Address | RAM SITA LANE | Age | 40 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||