Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08881 | Date 26/04/2023 |
| Token No | SM/22-23/9191 26/04/2023 | Serial | 021 |
| Patient Name | Mr. OM RAJBHAR | Contact No | 8902327409 |
| Address | 79 DEY STREET | Age | 15 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||