Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00249 | Date 25/09/2019 |
| Token No | SM/19-20/337 25/09/2019 | Serial | 013 |
| Patient Name | Mr. SHIVAM VERMA | Contact No | 8481020098 |
| Address | 153 NEW MAHESH SERAMPORE 712203 | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||