Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01017 | Date 18/02/2020 |
| Token No | SM/19-20/2406 18/02/2020 | Serial | 042 |
| Patient Name | Mr. SUMAN SAMANTA | Contact No | 8481002476 |
| Address | 65/1 WEST JANNAGAR ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 9 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||