Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 09653 | Date 17/07/2023 |
| Token No | SM/25-26/1986 10/09/2025 | Serial | 013 |
| Patient Name | Master ABHIJIT SURUL | Contact No | 8961635377 |
| Address | 109/B J N LAHIRI ROAD | Age | 11 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||