Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 09440 | Date 12/06/2025 |
| Token No | SM/25-26/3449 13/06/2025 | Serial | 002 |
| Patient Name | Mr. DEBJIT SURAI | Contact No | 9088491590 |
| Address | 15 RAILAND CIRCULAR ROAD SERAMPORE MAHESH 1 712202 | Age | 16 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||