Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 03541 | Date 30/12/2022 |
| Token No | SM/25-26/10321 12/11/2025 | Serial | 029 |
| Patient Name | Mr. DINESH CHANDRA CHAKRABORTY | Contact No | 8100608143 |
| Address | 30/72 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 71 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | 140/80 mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||