Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07790 | Date 24/11/2022 |
| Token No | SM/25-26/2624 14/11/2025 | Serial | 001 |
| Patient Name | Mr. JOYDEB KOIRI | Contact No | 8961451363 |
| Address | 8 A K C BHATTACHARYA ST | Age | 39 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||