Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00011 | Date 06/09/2019 |
| Token No | SM/19-20/420 30/09/2019 | Serial | 044 |
| Patient Name | Mr. ANKUSH ROY | Contact No | 8961941308 |
| Address | 10/B HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 6 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||