Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13260 | Date 21/07/2025 |
| Token No | SM/25-26/1300 21/07/2025 | Serial | 009 |
| Patient Name | Master LAKSHAYA SHAW | Contact No | 9330099173 |
| Address | INDIA JUTE MILL | Age | 4 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||