Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13890 | Date 22/12/2025 |
| Token No | SM/25-26/3090 22/12/2025 | Serial | 028 |
| Patient Name | Mr. SHIV KUMAR BHUINYA | Contact No | 8961118449 |
| Address | J.N. LAHIRI ROAD, JUBILI BASTI | Age | 31 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||