Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02610 | Date 25/07/2019 |
| Token No | SM/22-23/14390 24/01/2024 | Serial | 010 |
| Patient Name | Mr. TARKESHWAR NATH GIRI | Contact No | 8013341755 |
| Address | 79 DEY STREET | Age | 51 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||