Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03278 | Date 23/10/2019 |
| Token No | SM/22-23/9484 11/05/2023 | Serial | 009 |
| Patient Name | Mr. LALMOHAN RAJBHAR | Contact No | NOT GIVEN |
| Address | ram sita lane | Age | 58 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||