Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10277 | Date 06/12/2025 |
| Token No | SM/25-26/11597 06/12/2025 | Serial | 095 |
| Patient Name | Master RIBON SAIBON | Contact No | 8250979320 |
| Address | A/58/Y TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 1 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||