Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01219 | Date 18/03/2020 |
| Token No | SM/25-26/7888 12/09/2025 | Serial | 003 |
| Patient Name | Mr. SURAJIT DOLUI | Contact No | 8296454513 |
| Address | 34/B/19 B B GHOSH ROAD SERAMPORE 712203 | Age | 43 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||