Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13643 | Date 21/10/2025 |
| Token No | SM/25-26/2352 21/10/2025 | Serial | 005 |
| Patient Name | Master SNIGDHAJIT GHOSH | Contact No | 9073734262 |
| Address | 25 BHAGIRATHI LANE | Age | 5 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||