Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05146 | Date 13/12/2021 |
| Token No | SM/25-26/2186 08/10/2025 | Serial | 005 |
| Patient Name | Mr. PRABIR DOLUI | Contact No | 9748365969 |
| Address | BORA | Age | 37 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||