Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13303 | Date 26/07/2025 |
| Token No | SM/25-26/1409 26/07/2025 | Serial | 010 |
| Patient Name | Master ANGSHU GIRI | Contact No | |
| Address | DEY GHAT LANE | Age | 10 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||