Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01456 | Date 18/04/2020 |
| Token No | SM/19-20/3863 18/04/2020 | Serial | 012 |
| Patient Name | Mr. AKASH NAYAK | Contact No | 8961635475 |
| Address | 24 B B GHOSH ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||