Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 09976 | Date 18/09/2025 |
| Token No | SM/25-26/8191 19/09/2025 | Serial | 012 |
| Patient Name | Mr. TAPAN KUMAR BRAHMA | Contact No | 9062843216 |
| Address | 16 HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 62 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||