Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09552 | Date 09/07/2025 |
| Token No | SM/25-26/5781 04/08/2025 | Serial | 038 |
| Patient Name | Baby BAISHNABI SHARMA | Contact No | 7890118316 |
| Address | DR NOORIE BYE LANE CHAMPDANI BAIDYABATI M 712222 | Age | 4 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||