Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 16277 | Date 15/11/2025 |
| Token No | SM/25-26/8041 17/11/2025 | Serial | 001 Last Visit: 17/11/2025 |
| Patient Name | Mr. GOUTAM DAS | Contact No | 7890646614 |
| Address | 32 G T ROAD NABAGRAM BAIDYABATI (M) | Age | 59 Years,10 Months,15 Days Male |
| Token For | Pathology Test | Charge | Free |
| B.P | 122/70 mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | 152 cm BMI: 22.074100 |
| Diagnosis | |||