Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 16203 | Date 25/10/2025 |
| Token No | SM/25-26/7302 25/10/2025 | Serial | 008 Last Visit: 25/10/2025 |
| Patient Name | Mr. GOUTAM BANERJEE | Contact No | |
| Address | GOPALPUR, HOOGHLY | Age | 44 Years,11 Months,23 Days Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||