Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02496 | Date 20/08/2022 |
| Token No | SM/25-26/9996 05/11/2025 | Serial | 053 |
| Patient Name | Mr. SAIFUL MOLLA | Contact No | |
| Address | BHOLADANGA GAYESHPUR SANTIPUR NADIA 741404 | Age | 21 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||