Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02143 | Date 30/05/2019 |
| Token No | SM/18-19/4408 24/06/2019 | Serial | 038 |
| Patient Name | Mrs. MITALI BARAL | Contact No | 9883670276 |
| Address | 24A PANCHANAN TALA LANE | Age | 43 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||