Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01153 | Date 11/03/2020 |
| Token No | SM/19-20/2977 11/03/2020 | Serial | 031 |
| Patient Name | Mr. SHIVAM KUMAR DUTTA | Contact No | 8789802796 |
| Address | 43/32/B/5 PRABASHNAGAR SERAMPORE 712249 | Age | 13 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||