Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 11877 | Date 01/08/2024 |
| Token No | SM/25-26/1146 10/07/2025 | Serial | 010 |
| Patient Name | Mr. JAGMOHAN CHOUDHURY | Contact No | 7450075904 |
| Address | 62/A RAY LAND ROAD | Age | 75 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||