Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00290 | Date 22/10/2019 |
| Token No | SM/19-20/608 08/11/2019 | Serial | 008 |
| Patient Name | Mr. RAJ SINGH | Contact No | 7044783945 |
| Address | PRABASHNAGAR SERAMPORE 712249 | Age | 14 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||