Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03970 | Date 21/03/2023 |
| Token No | SM/25-26/11115 28/11/2025 | Serial | 004 |
| Patient Name | Mr. MORSALIM MOLLA | Contact No | 9064500903 |
| Address | BHOLADANGA GAYESHPUR SANTIPUR | Age | 22 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||