Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13734 | Date 14/11/2025 |
| Token No | SM/25-26/2627 14/11/2025 | Serial | 004 |
| Patient Name | Master ANONYO DE | Contact No | 9830957233 |
| Address | 613/B G.T. ROAD | Age | 12 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||