Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02665 | Date 09/09/2022 |
| Token No | SM/25-26/6131 09/08/2025 | Serial | 031 |
| Patient Name | Mr. AYAN DHAM | Contact No | 7688020247 |
| Address | D/149/Y TARAPUKUR GOVT QUARTER MALLICKPARA SERAMPORE 712203 | Age | 47 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||