Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 06301 | Date 06/07/2022 |
| Token No | SM/22-23/3776 06/07/2022 | Serial | 020 |
| Patient Name | Mrs. SUMITA BARAL | Contact No | NOT GIVEN |
| Address | 4 BHAGIRATHI LANE | Age | 28 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||