Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08504 | Date 03/03/2023 |
| Token No | SM/22-23/8178 03/03/2023 | Serial | 011 |
| Patient Name | Mr. MAHANGU SHA | Contact No | 9872400116 |
| Address | 6 NAYA BAGAN | Age | 66 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||