Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 09256 | Date 05/06/2023 |
| Token No | SM/24-25/21238 06/03/2025 | Serial | 024 |
| Patient Name | Mr. JAYANTA NANDAN | Contact No | 8274009821 |
| Address | 7/5 PATUA PARA LANE | Age | 28 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||