Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01162 | Date 12/03/2020 |
| Token No | SM/19-20/3015 12/03/2020 | Serial | 031 |
| Patient Name | Mr. PAWAN KR RAM | Contact No | 9163514126 |
| Address | 65/A/8 M J ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 13 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||