Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07146 | Date 27/09/2022 |
| Token No | SM/22-23/7604 31/01/2023 | Serial | 051 |
| Patient Name | Mrs. MONGALA ADHIKARI | Contact No | 9804286784 |
| Address | 43/C DHULI PARA LANE | Age | 64 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||