Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00314 | Date 01/11/2019 |
| Token No | SM/19-20/506 01/11/2019 | Serial | 002 |
| Patient Name | Mr. SOUMADEEP GHOSH | Contact No | 9874330462 |
| Address | MALLICKPARA SERAMPORE | Age | 13 Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||