Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 11511 | Date 10/05/2024 |
| Token No | SM/25-26/2082 18/09/2025 | Serial | 005 |
| Patient Name | Mrs. RENUKA ADHIKARI | Contact No | 9007604057 |
| Address | 40 DEY BAGAN LANE | Age | 86 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||