Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02636 | Date 06/09/2022 |
| Token No | SM/25-26/2065 15/05/2025 | Serial | 028 |
| Patient Name | Mr. AJIBUL BISWAS | Contact No | 8609060214 |
| Address | BHOLADANGA GAYESHPUR HAZRATALA 741404 | Age | 20 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||