Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00586 | Date 20/12/2019 |
| Token No | SM/19-20/4072 04/05/2020 | Serial | 019 |
| Patient Name | Miss DEBALINA BHATTACHARYYA | Contact No | 9143280496 |
| Address | 141 2NO RAJYADHAPUR GOVT COLONY MALLICKPARA SERAMPORE 712203 | Age | 10 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||