Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07435 | Date 28/10/2022 |
| Token No | SM/25-26/2185 08/10/2025 | Serial | 004 |
| Patient Name | Mrs. RUMKI DOLUI | Contact No | 9748365969 |
| Address | JHAKARI | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||