Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10165 | Date 13/11/2025 |
| Token No | SM/25-26/10332 13/11/2025 | Serial | 001 |
| Patient Name | Mr. CHINMOY BOSE | Contact No | 9051508136 |
| Address | 30/49 TARAPUKUR COLONY SERAMPORE 712203 | Age | 60 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||