Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01122 | Date 04/03/2020 |
| Token No | SM/19-20/2786 04/03/2020 | Serial | 017 |
| Patient Name | Mr. SK ASIS | Contact No | 8777416034 |
| Address | 7 NO TARAPUKUR LANE CHAKAPARA SERAMPORE 712203 | Age | 10 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 21 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||