Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 10345 | Date 30/12/2025 |
| Token No | SM/25-26/12569 31/12/2025 | Serial | 016 |
| Patient Name | Mr. JATINDRA KUMAR JARIWALA | Contact No | 9831536058 |
| Address | 34/B/64 B B GHOSH ROAD SERAMPORE M 712203 | Age | 82 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||