Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09099 | Date 18/05/2023 |
| Token No | SM/22-23/9653 18/05/2023 | Serial | 013 |
| Patient Name | Mr. DASARATH RAJBHAR | Contact No | 8674958400 |
| Address | 9 NO LINE INDIA JUTE MILL | Age | 59 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||