Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00396 | Date 19/11/2019 |
| Token No | SM/19-20/722 19/11/2019 | Serial | 002 |
| Patient Name | Miss MEGNA PAL | Contact No | |
| Address | 102 NEW MAHESH SERAMPORE | Age | 6 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||