Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 10342 | Date 29/12/2025 |
| Token No | SM/25-26/12486 29/12/2025 | Serial | 055 |
| Patient Name | Master ADI RASUA | Contact No | 8420327276 |
| Address | HARIJAN BASTI B B GHOSH ROAD SERAMPORE 712203 | Age | 5 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||