Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13717 | Date 10/11/2025 |
| Token No | SM/25-26/2567 10/11/2025 | Serial | 019 |
| Patient Name | Mr. SASWATA BOSU | Contact No | 8335837762 |
| Address | 132/D T B STREET | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||