Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13526 | Date 15/09/2025 |
| Token No | SM/25-26/2059 15/09/2025 | Serial | 016 |
| Patient Name | Master ARYAN ROY | Contact No | 8420281846 |
| Address | 53 DEY STREET | Age | 8 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||