Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00591 | Date 21/12/2019 |
| Token No | SM/19-20/1217 21/12/2019 | Serial | 006 |
| Patient Name | Mr. ANIKET MAHATO | Contact No | 7278736479 |
| Address | 3/A DR B R AMBEDKAR LANE MALLICKPARA SERAMPORE 712203 | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 22 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||