Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00621 | Date 01/09/2018 |
| Token No | SM/22-23/3012 18/05/2022 | Serial | 011 |
| Patient Name | Miss MITHU BARAL | Contact No | 9088392735 |
| Address | PANCHANAN TALA LANE | Age | 56 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||