Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00892 | Date 07/02/2020 |
| Token No | SM/25-26/12074 17/12/2025 | Serial | 021 |
| Patient Name | Mr. PROBAL BISWAS | Contact No | 6290680766 |
| Address | 152/1 NISITH SEN SARANI SITALATALA BAIDYABATI 712222 | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||