Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13254 | Date 19/07/2025 |
| Token No | SM/25-26/1287 19/07/2025 | Serial | 006 |
| Patient Name | Master SRIBEDYA DAS | Contact No | 9051922351 |
| Address | 110 J.N. LAHIRI ROAD | Age | 3 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||