Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01132 | Date 06/03/2020 |
| Token No | SM/19-20/2855 06/03/2020 | Serial | 003 |
| Patient Name | Miss TRISHA DAS | Contact No | 9883665354 |
| Address | 34/B/39 SUKANTA PALLY PRABASHNAGAR SERAMPORE 712203 | Age | 12 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||