Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13218 | Date 10/07/2025 |
| Token No | SM/25-26/1212 14/07/2025 | Serial | 016 |
| Patient Name | Mr. GOPESH MUKHERJEE. | Contact No | 8017044075 |
| Address | 5 CHATTERJEE LANE | Age | 49 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||