Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13816 | Date 03/12/2025 |
| Token No | SM/25-26/2855 03/12/2025 | Serial | 004 |
| Patient Name | Mr. RAJESH GIRI | Contact No | 7044395907 |
| Address | 6 RAM SITA LANE | Age | 40 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||