Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13284 | Date 24/07/2025 |
| Token No | SM/25-26/1371 24/07/2025 | Serial | 010 |
| Patient Name | Master SHIBNATH ROY | Contact No | 8697613975 |
| Address | 55 ROYLAND ROAD | Age | 13 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||