Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07069 | Date 16/09/2022 |
| Token No | SM/22-23/5172 16/09/2022 | Serial | 015 |
| Patient Name | Mr. ASHOK RAJBHAR | Contact No | 8444904288 |
| Address | 79 DEY STREET | Age | 42 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||