Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00729 | Date 14/01/2020 |
| Token No | SM/19-20/1575 14/01/2020 | Serial | 009 |
| Patient Name | Mrs. PURNIMA SARMA | Contact No | |
| Address | NEW POST OFFICE PRABASHNAGAR 712249 | Age | 65 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||