Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01033 | Date 20/02/2020 |
| Token No | SM/22-23/3646 20/10/2022 | Serial | 012 |
| Patient Name | Mr. BHASKAR SHAW | Contact No | 9903684370 |
| Address | 220 NEW MAHESH KATAPUL SERAMPORE 712203 | Age | 7 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||