Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00069 | Date 09/09/2019 |
| Token No | SM/19-20/70 09/09/2019 | Serial | 027 |
| Patient Name | Miss SREEJITA DAS | Contact No | 9748005678 |
| Address | B/98/Y TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 6 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||