Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00495 | Date 03/12/2019 |
| Token No | SM/19-20/947 03/12/2019 | Serial | 012 |
| Patient Name | Baby BHUMI GHARAI | Contact No | 6289345403 |
| Address | 174/Y TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 5 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||