Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 09588 | Date 18/07/2025 |
| Token No | SM/25-26/12174 20/12/2025 | Serial | 014 |
| Patient Name | Mr. AVISHEK DUTTA | Contact No | 7439062744 |
| Address | 2/71 MAHESH COLONY 712202 | Age | 22 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||