Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01522 | Date 29/04/2020 |
| Token No | SM/25-26/10272 11/11/2025 | Serial | 003 |
| Patient Name | Mr. SHUBHAJIT THAKUR | Contact No | 9007899416 |
| Address | 65/25/52 M J ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 22 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||