Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 12138 | Date 23/09/2024 |
| Token No | SM/25-26/2614 13/11/2025 | Serial | 016 |
| Patient Name | Mr. HRIDARSAN MONDAL | Contact No | 9647195545 |
| Address | 2 BROJO DUTTA LANE | Age | 74 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||