Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07100 | Date 21/09/2022 |
| Token No | SM/22-23/11692 17/08/2023 | Serial | 012 |
| Patient Name | Mrs. RAMBHA GIRI | Contact No | 8777369584 |
| Address | 4 DEY GHAT LANE | Age | 36 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||