Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13723 | Date 12/11/2025 |
| Token No | SM/25-26/2600 13/11/2025 | Serial | 002 |
| Patient Name | Mrs. LATIKA ADHIKARI | Contact No | 8017575649 |
| Address | 39 DEY BAGAN | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||