Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07565 | Date 17/02/2020 |
| Token No | SM/19-20/18258 17/02/2020 | Serial | 082 Last Visit: 30/04/2020 |
| Patient Name | Mrs. NURJAHAN BEGAM | Contact No | 8420174054 |
| Address | 21 KANHAI DEWAN TALA LANE SERAMPORE | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||