Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 06710 | Date 11/08/2022 |
| Token No | SM/22-23/4490 11/08/2022 | Serial | 026 |
| Patient Name | Mr. MAHENDRA KOIRI | Contact No | |
| Address | DEY GHAT LANE | Age | 61 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||