Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09789 | Date 21/08/2025 |
| Token No | SM/25-26/6670 21/08/2025 | Serial | 036 |
| Patient Name | Mr. ALI ASGAR SK | Contact No | 8918266689 |
| Address | MALLICKPARA SERAMPORE 712203 | Age | 11 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||