Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03059 | Date 16/09/2019 |
| Token No | SM/18-19/6529 17/09/2019 | Serial | 029 |
| Patient Name | Mrs. RAMBHA GIRI | Contact No | 9433640733 |
| Address | 4 DEY GHAT LANE | Age | 33 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||