Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00528 | Date 10/12/2019 |
| Token No | SM/19-20/1040 10/12/2019 | Serial | 006 |
| Patient Name | Master SAGAR KOLEY | Contact No | 9874312313 |
| Address | CHAKLAPARA PRABASHNAGAR SERAMPORE 712249 | Age | 4 YEAR 8 MONTH Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||