Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 13366 | Date 11/08/2025 |
| Token No | SM/25-26/1628 11/08/2025 | Serial | 021 |
| Patient Name | Master SUMIT GHOSH | Contact No | 9330637225 |
| Address | 14/5 KHATIR BAZAR MAHESH | Age | 11 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||