Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 12400 | Date 27/11/2024 |
| Token No | SM/25-26/1250 16/07/2025 | Serial | 020 |
| Patient Name | Mr. ASIT GHOSH | Contact No | 6290803473 |
| Address | 26 J.N. LAHIRI ROAD | Age | 64 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||