Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01279 | Date 02/11/2018 |
| Token No | SM/18-19/1762 02/11/2018 | Serial | 014 |
| Patient Name | Master SIVAM RAO | Contact No | NOT GIOVEN |
| Address | JOLKOL | Age | 4 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||