Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13652 | Date 25/10/2025 |
| Token No | SM/25-26/2381 25/10/2025 | Serial | 003 |
| Patient Name | Master SREYANSH BARIK | Contact No | 7439163691 |
| Address | 6A DOSTI LANE | Age | 2 months Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||