Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10062 | Date 15/10/2025 |
| Token No | SM/25-26/9155 15/10/2025 | Serial | 044 |
| Patient Name | Master ARPAN GHOSH | Contact No | 9874748639 |
| Address | 210/53/E NABAGRAM GHOSHAL PARA BAIDYABATI M 712201 | Age | 1 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||