Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09478 | Date 18/06/2025 |
| Token No | SM/25-26/3707 18/06/2025 | Serial | 056 |
| Patient Name | Mr. SAJIB MOLLA | Contact No | |
| Address | BHOLADANGA GAYESHPUR SANTIPUR NADIA | Age | 17 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||