Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 03762 | Date 24/01/2020 |
| Token No | SM/22-23/7170 27/12/2022 | Serial | 014 |
| Patient Name | Mrs. GITA RAJBHAR | Contact No | 8820041790 |
| Address | TIN BAZAR | Age | 48 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||