Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13861 | Date 12/12/2025 |
| Token No | SM/25-26/2978 12/12/2025 | Serial | 004 |
| Patient Name | Master PURBO BISWAS | Contact No | 9062161559 |
| Address | 137A G.T. ROAD, MANIKTALA | Age | 10 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||