Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10296 | Date 13/12/2025 |
| Token No | SM/25-26/11914 13/12/2025 | Serial | 059 |
| Patient Name | Master SEKH SAHADUT | Contact No | 6290879108 |
| Address | 1/D CHILEKHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 4 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||