Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00143 | Date 16/09/2019 |
| Token No | SM/19-20/155 16/09/2019 | Serial | 019 |
| Patient Name | Mr. ARYAN KUMAR | Contact No | 8697934818 |
| Address | 253 NEW MAHESH SERAMPORE 712203 | Age | 6 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||