Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01442 | Date 16/04/2020 |
| Token No | SM/19-20/3824 16/04/2020 | Serial | 021 |
| Patient Name | Mr. SURAJ RAJBANSHI | Contact No | 7890730749 |
| Address | 43/26 PRABASHNAGAR SERAMPORE 712249 | Age | 11 Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||