Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13666 | Date 28/10/2025 |
| Token No | SM/25-26/2410 28/10/2025 | Serial | 007 |
| Patient Name | Mr. JITENDAR ROY.,. | Contact No | 8013280906 |
| Address | 118 RAM SITA LANE,SERAMPORE | Age | 30 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||