Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06926 | Date 06/09/2022 |
| Token No | SM/22-23/12642 25/09/2023 | Serial | 003 |
| Patient Name | Mrs. PARBATI RAJBHAR | Contact No | 9748377653 |
| Address | 17 DEY STREET PAL BAGAN | Age | 69 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||