Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01355 | Date 04/04/2020 |
| Token No | SM/22-23/5071 07/12/2022 | Serial | 023 |
| Patient Name | Mrs. SUMAN ADHIKARY | Contact No | |
| Address | PROVASNAGER | Age | 27 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||