Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 10070 | Date 16/10/2025 |
| Token No | SM/25-26/9239 16/10/2025 | Serial | 039 |
| Patient Name | Mr. PRIYANGSHU KUMAR | Contact No | 8274034586 |
| Address | 10/L HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 11 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||