Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 15899 | Date 14/08/2025 |
| Token No | SM/25-26/4950 18/08/2025 | Serial | 007 Last Visit: 20/08/2025 |
| Patient Name | Mr. SHAMBHU NATH BANGAL | Contact No | 9331681223 |
| Address | 11 DOCTOR BAGAN LANE SERAMPORE | Age | 61 Years,3 Months,5 Days Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||