Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 14987 | Date 26/10/2026 |
| Token No | SM/25-26/6067 26/10/2026 | Serial | 017 |
| Patient Name | Baby RAI GHOSHAL | Contact No | 9674540163 |
| Address | 86 NO B P 2ND LANE | Age | DOB: 06.09.26 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||