Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01447 | Date 20/12/2018 |
| Token No | SM/18-19/5943 27/08/2019 | Serial | 023 |
| Patient Name | Master G SLOKE RAO | Contact No | 9903531379 |
| Address | RAM SITA LANE | Age | 9 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||