Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01005 | Date 18/02/2020 |
| Token No | SM/19-20/2610 26/02/2020 | Serial | 015 |
| Patient Name | Miss SHARMILA PAL | Contact No | 9123013641 |
| Address | 2/C TARAPUKUR LANE SERAMPORE 712203 | Age | 11 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||