Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 09963 | Date 15/09/2025 |
| Token No | SM/25-26/8025 15/09/2025 | Serial | 041 |
| Patient Name | Master MD QURBAN | Contact No | 8910497610 |
| Address | 23 L B S ROAD SERAMPORE 712201 | Age | 5 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||