Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01473 | Date 20/04/2020 |
| Token No | SM/19-20/3897 20/04/2020 | Serial | 028 |
| Patient Name | Mrs. GYATRI GHORUI | Contact No | |
| Address | HARIJAN BASTI PRABASHNAGAR SERAMPORE 712203 | Age | 8 YEAR 6 MONTH Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||