Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10499 | Date 25/09/2023 |
| Token No | SM/25-26/2034 13/09/2025 | Serial | 003 |
| Patient Name | Mr. PIYUSH RAJHANSA | Contact No | 9123633195 |
| Address | 40 BHAGIRATHI LANE | Age | 39 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||