Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 04163 | Date 11/05/2023 |
| Token No | SM/25-26/87 02/04/2025 | Serial | 058 |
| Patient Name | Mr. AYUSH KUMAR SAH | Contact No | 8481047538 |
| Address | 10/B HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 6 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||