Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13680 | Date 31/10/2025 |
| Token No | SM/25-26/2459 31/10/2025 | Serial | 003 |
| Patient Name | Mr. ISHAAN BANERJEE | Contact No | 7003859278 |
| Address | 15 BROJODUTTA LANE | Age | 6 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||