Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 14572 | Date 08/07/2026 |
| Token No | SM/25-26/6069 26/10/2026 | Serial | 019 |
| Patient Name | Master ANIRBAN CHAKRABORTY | Contact No | 6290700306 |
| Address | 43 PANCHANANTALA LANE | Age | DOB 3.12.25 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||