Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01141 | Date 07/03/2020 |
| Token No | SM/19-20/2927 07/03/2020 | Serial | 025 |
| Patient Name | Mr. SHIBAM GUPTA | Contact No | 7890085109 |
| Address | 13/52 B B GHOSH ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 7 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 11 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||