Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09946 | Date 12/09/2025 |
| Token No | SM/25-26/7911 12/09/2025 | Serial | 026 |
| Patient Name | Mr. ANKIT DAS | Contact No | 9748827008 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 6 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||