Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00555 | Date 14/12/2019 |
| Token No | SM/19-20/1114 14/12/2019 | Serial | 010 |
| Patient Name | Mr. SURAJ KUMAR | Contact No | |
| Address | NEW MAHESH SERAMPORE | Age | 9 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||