Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 08419 | Date 21/02/2023 |
| Token No | SM/22-23/10912 15/07/2023 | Serial | 011 |
| Patient Name | Mrs. SHARMISTA CHITRAKAR | Contact No | 6290203481 |
| Address | 6/B PATUA PARA LANE | Age | 25 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||