Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01181 | Date 14/03/2020 |
| Token No | SM/19-20/3089 14/03/2020 | Serial | 026 |
| Patient Name | Mr. SRAWAN KUMAR | Contact No | 9163171620 |
| Address | 60 PRAVASHNAGAR SERAMPORE 712249 | Age | 7 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||