Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01092 | Date 27/02/2020 |
| Token No | SM/19-20/2638 27/02/2020 | Serial | 013 |
| Patient Name | Mr. AYUSH KUMAR ROY | Contact No | 7596976679 |
| Address | GHORAMARA PURBAPARA SERAMPORE | Age | 9 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||