Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12916 | Date 23/04/2025 |
| Token No | SM/25-26/217 23/04/2025 | Serial | 028 |
| Patient Name | Master BAIBHAB BARIK | Contact No | 9123745150 |
| Address | 5 DOSTI LANE | Age | 5 MONTHS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||