Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03613 | Date 16/01/2023 |
| Token No | SM/22-23/17522 17/01/2024 | Serial | 007 |
| Patient Name | Mr. MARUF HOSEN MOLLA | Contact No | 8695372788 |
| Address | MALLICKPARA SERAMPORE 712203 | Age | 18 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||