Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01232 | Date 19/03/2020 |
| Token No | SM/19-20/3253 19/03/2020 | Serial | 011 |
| Patient Name | Mr. ROHAN GIRI | Contact No | 7890150114 |
| Address | PRAMOD PALLY DAKSHIN RAJYADHARPUR SERAMPORE 712203 | Age | 8 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||