Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 10300 | Date 13/12/2025 |
| Token No | SM/25-26/12014 16/12/2025 | Serial | 014 |
| Patient Name | Mr. SHANKAR PRASAD SHAW | Contact No | 9748082368 |
| Address | 13/86 B B GHOSH ROAD SERAMPORE 712203 | Age | 47 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||