Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 09412 | Date 19/06/2023 |
| Token No | SM/25-26/3026 17/12/2025 | Serial | 014 |
| Patient Name | Mr. KALI PROSAD BANERJEE | Contact No | 9432270957 |
| Address | 83 THAKURBATI STREET | Age | 51 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||