Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13870 | Date 15/12/2025 |
| Token No | SM/25-26/3000 15/12/2025 | Serial | 002 |
| Patient Name | Miss KAJAL ADHIKARI | Contact No | 8420969520 |
| Address | 14 PANCHANANTALA LANE | Age | 18 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||