Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 11599 | Date 03/06/2024 |
| Token No | SM/24-25/20838 05/02/2025 | Serial | 010 |
| Patient Name | Mr. SANJIB KUMAR GIRI | Contact No | 9433640733 |
| Address | 4 DEY GHAT LANE | Age | 45 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||