Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13232 | Date 15/07/2025 |
| Token No | SM/25-26/1223 15/07/2025 | Serial | 004 |
| Patient Name | Master KANHA SHAW | Contact No | 9523718763 |
| Address | S.B. GHOSH LANE | Age | 12 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||