Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01147 | Date 11/03/2020 |
| Token No | SM/19-20/3583 01/04/2020 | Serial | 024 |
| Patient Name | Mr. CHANDAN GIRI | Contact No | 7890150114 |
| Address | A/1 RAYLAND ROAD SERAMPORE M 712202 | Age | 16 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||