Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00636 | Date 31/12/2019 |
| Token No | SM/25-26/10972 25/11/2025 | Serial | 001 |
| Patient Name | Mr. GYANI DAS | Contact No | 8697358402 |
| Address | D CRUZE GARDEN ROAD SERAMPORE 712203 | Age | 74 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||