Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05066 | Date 23/11/2021 |
| Token No | SM/22-23/6568 23/11/2022 | Serial | 016 |
| Patient Name | Mr. SHANKAR RAJBHAR | Contact No | 9748377653 |
| Address | 17 PAL BAGAN | Age | 62 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||