Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13536 | Date 18/09/2025 |
| Token No | SM/25-26/2103 18/09/2025 | Serial | 026 |
| Patient Name | Master BIKI MONDAL | Contact No | 8777637380 |
| Address | 16 SITAL SARKAR LANE | Age | 10 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||