Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00969 | Date 15/02/2020 |
| Token No | SM/19-20/2287 15/02/2020 | Serial | 021 |
| Patient Name | Miss SANA MALLICK | Contact No | 9836911457 |
| Address | 12/C TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 7 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||