Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01156 | Date 11/03/2020 |
| Token No | SM/19-20/3351 23/03/2020 | Serial | 003 |
| Patient Name | Mr. RAHUL KANTI | Contact No | 9007783095 |
| Address | 9/A TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 14 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||