Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09966 | Date 15/09/2025 |
| Token No | SM/25-26/8057 15/09/2025 | Serial | 073 |
| Patient Name | Mr. INTAJUL MOLLA | Contact No | 8927455221 |
| Address | BHOLADANGA GAYESHPUR SANTIPUR NADIA | Age | 20 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||