Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01553 | Date 02/05/2020 |
| Token No | SM/19-20/4049 02/05/2020 | Serial | 015 |
| Patient Name | Master SK AHIL | Contact No | |
| Address | MALLICKPARA SERAMPORE 712203 | Age | 4 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||