Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00278 | Date 30/09/2019 |
| Token No | SM/19-20/3873 20/04/2020 | Serial | 004 |
| Patient Name | Miss DEBANGI BHATTACHARYA | Contact No | 9432010939 |
| Address | 141 2 NO RAJYADHARPUR GOVT COLONY MALLICKPARA SERAMPORE 712203 | Age | 8 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||