Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00274 | Date 30/09/2019 |
| Token No | SM/19-20/412 30/09/2019 | Serial | 036 |
| Patient Name | Mr. ISHAN GUPTA | Contact No | 6289038656 |
| Address | 122 PRABASHNAGAR,SERAMPORE 712249 | Age | 12 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||