Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00300 | Date 25/10/2019 |
| Token No | SM/19-20/470 25/10/2019 | Serial | 001 |
| Patient Name | Mr. ANUBHAB BANERJEE | Contact No | 9474401441 |
| Address | 30/3 TARAPUKUR LANE SERAMPORE 712203 | Age | 15 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||