Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00002 | Date 05/09/2019 |
| Token No | SM/19-20/2 05/09/2019 | Serial | 002 |
| Patient Name | Master SK HAARIS | Contact No | 7047023587 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 3 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 100/78 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||