Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00224 | Date 23/09/2019 |
| Token No | SM/19-20/311 24/09/2019 | Serial | 020 |
| Patient Name | Miss KESHARI SINGH | Contact No | 9230276045 |
| Address | 28/1 TARAPUKUR LANE SERAMPORE 712203 | Age | 8 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||