Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00624 | Date 30/12/2019 |
| Token No | SM/19-20/1301 30/12/2019 | Serial | 004 |
| Patient Name | Baby ANUSKA BERA | Contact No | |
| Address | 3/D DICRUZ GARDEM LANE MALLICKPARA SERAMPORE | Age | 2 YEAR 3 MONTH Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||