Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 10073 | Date 16/10/2025 |
| Token No | SM/25-26/9696 30/10/2025 | Serial | 053 |
| Patient Name | Master DHYANSHU CHOWDHURY | Contact No | 9304251561 |
| Address | 5/1/Z DINABANDHU CHATTERHEE LANE SERAMPORE 712202 | Age | 3 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||