Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09788 | Date 21/08/2025 |
| Token No | SM/25-26/7167 30/08/2025 | Serial | 029 |
| Patient Name | Mr. SAYAD HASAN | Contact No | 8653118574 |
| Address | MALLICKPARA SERAMPORE 712203 | Age | 12 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||