Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13294 | Date 25/07/2025 |
| Token No | SM/25-26/1435 28/07/2025 | Serial | 026 |
| Patient Name | Mr. GANESH JANA | Contact No | 8961338452 |
| Address | 5 DOSTI LANE | Age | 48 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||