Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00767 | Date 20/01/2020 |
| Token No | SM/19-20/2915 07/03/2020 | Serial | 013 |
| Patient Name | Master SAMIR SAHA | Contact No | 9088265326 |
| Address | 55A/16 JANNAGAR ROAD MALLICKPARA 712203 | Age | 4 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||