Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00726 | Date 11/01/2020 |
| Token No | SM/19-20/2392 18/02/2020 | Serial | 028 |
| Patient Name | Mr. RISMAN RUDRA | Contact No | 9332223350 |
| Address | 30/22 TARAPUKUR LANE SERAMPORE 712203 | Age | 7 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||