Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00415 | Date 21/11/2019 |
| Token No | SM/19-20/770 21/11/2019 | Serial | 004 |
| Patient Name | Mr. SAMRAT SARKAR | Contact No | 6289513679 |
| Address | 43/32/C GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 9 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||