Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13035 | Date 24/05/2025 |
| Token No | SM/25-26/567 24/05/2025 | Serial | 027 |
| Patient Name | Master ADIPTA PAL | Contact No | 8420358923 |
| Address | 92/B/1 DFEY STREET | Age | 3YR 5 MONTHS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||