Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09615 | Date 23/07/2025 |
| Token No | SM/25-26/5184 23/07/2025 | Serial | 025 |
| Patient Name | Mr. NASBUL NAIYA | Contact No | 9832251180 |
| Address | MALLICKPARA SERAMPORE 712203 | Age | 10 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||