Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00098 | Date 13/09/2019 |
| Token No | SM/19-20/683 15/11/2019 | Serial | 019 |
| Patient Name | Miss KOYEL ADHIKARI | Contact No | 8478911858 |
| Address | SUKANTA PALLY PRABASHNAGAR SERAMPORE 712203 | Age | 12 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||