Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01770 | Date 30/05/2022 |
| Token No | SM/25-26/9275 16/10/2025 | Serial | 075 |
| Patient Name | Mr. MANIK DOLUI | Contact No | 8240511674 |
| Address | 38/B B B GHOSH ROAD SERAM[PORE 712203 | Age | 79 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||