Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13636 | Date 18/10/2025 |
| Token No | SM/25-26/2370 22/10/2025 | Serial | 011 |
| Patient Name | Mr. KALIPADA GHOSH | Contact No | 8101737036 |
| Address | 3 SHYAMA CHARAN LAHIRI LANE | Age | 45 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||