Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00099 | Date 13/09/2019 |
| Token No | SM/19-20/106 13/09/2019 | Serial | 005 |
| Patient Name | Mr. BISHAL ADHIKARY | Contact No | 8478911858 |
| Address | SUKANTA PALLY PRABASHNAGAR SERAMPORE 712203 | Age | 8 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||