Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09236 | Date 05/06/2023 |
| Token No | SM/25-26/1624 11/08/2025 | Serial | 017 |
| Patient Name | Mr. ANIL PAL | Contact No | 9748664898 |
| Address | 45 N L BHATTACHARJEE STREET | Age | 13 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||