Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02042 | Date 10/05/2019 |
| Token No | SM/18-19/3583 10/05/2019 | Serial | 009 |
| Patient Name | Master YASHWIN RAO | Contact No | NOT GIVEN |
| Address | 58 INDIA JUTE MILL | Age | 7 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||