Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06796 | Date 22/08/2022 |
| Token No | SM/22-23/14723 10/02/2024 | Serial | 002 |
| Patient Name | Mrs. PRATIMA RAJBHAR | Contact No | NOT GIVEN |
| Address | 5 DOSTI LANE | Age | 61 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||