Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03887 | Date 05/03/2020 |
| Token No | SM/25-26/3027 17/12/2025 | Serial | 015 |
| Patient Name | Mr. TARUN DEY | Contact No | 6291003731 |
| Address | 3 A K C BHATTACHARJEE STREET | Age | 72 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||