Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 14961 | Date 13/10/2026 |
| Token No | SM/25-26/6055 26/10/2026 | Serial | 005 |
| Patient Name | Mr. BISTU CHARAN METE | Contact No | 9903579630 |
| Address | 11 A.B. GARDEN LANE | Age | 63 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||