Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00529 | Date 10/12/2019 |
| Token No | SM/19-20/1186 20/12/2019 | Serial | 002 |
| Patient Name | Mr. PRINCE RAM | Contact No | 9883845645 |
| Address | 107/E PRABASHNAGAR SERAMPORE 712249 | Age | 6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||