Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 11069 | Date 26/08/2026 |
| Token No | SM/25-26/20663 27/08/2026 | Serial | 028 |
| Patient Name | Mr. SUJOY DOM | Contact No | 8250185200 |
| Address | HARIJAN BASTI B B GHOSH ROAD SERAMPORE 712203 | Age | 21 Years,6 Months,13 Days Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||