Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 11517 | Date 13/05/2024 |
| Token No | SM/25-26/2390 25/10/2025 | Serial | 012 |
| Patient Name | Master NILASISH ROY | Contact No | 7044008574 |
| Address | 6 DEY GHAT LANE | Age | 2 year 10months Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||