Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02615 | Date 26/07/2019 |
| Token No | SM/22-23/14428 25/01/2024 | Serial | 026 |
| Patient Name | Mr. RAMA SUNDAR KOIRI | Contact No | 7003698525 |
| Address | PAL BAGAN | Age | 66 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||