Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 08921 | Date 28/04/2023 |
| Token No | SM/25-26/721 09/06/2025 | Serial | 037 |
| Patient Name | Mr. SANJAY DUTTA | Contact No | 9051480241 |
| Address | 3/A BROJO DUTTA LANE | Age | 60 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||