Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00460 | Date 26/11/2019 |
| Token No | SM/19-20/865 26/11/2019 | Serial | 005 |
| Patient Name | Mrs. ROSNI SHARMA | Contact No | 8100825118 |
| Address | 180 NEW MAHESH SERAMPORE 712203 | Age | 10 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||