Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06802 | Date 23/08/2022 |
| Token No | SM/22-23/4653 23/08/2022 | Serial | 006 |
| Patient Name | Mrs. LATA KUMARI RAJBHAR | Contact No | 9432071704 |
| Address | 10 DEY STREET | Age | 29 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||