Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 10204 | Date 29/08/2023 |
| Token No | SM/22-23/13063 17/10/2023 | Serial | 008 |
| Patient Name | Mr. RAMSAKHI RAI | Contact No | |
| Address | BARALBAGAN LANE | Age | 50 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||