Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 11873 | Date 31/07/2024 |
| Token No | SM/24-25/19671 13/11/2024 | Serial | 002 |
| Patient Name | Mr. TRINATH BARIK | Contact No | 8420527002 |
| Address | 19 DOSTI LANE | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||