Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01004 | Date 18/02/2020 |
| Token No | SM/19-20/2381 18/02/2020 | Serial | 017 |
| Patient Name | Mr. SHUBHADEEP SAHA | Contact No | 9804302827 |
| Address | 65/33 FIRINGI DANGA ROAD SERAMPORE 712203 | Age | 11 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 28 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||