Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02930 | Date 30/08/2019 |
| Token No | SM/18-19/6441 16/09/2019 | Serial | 001 |
| Patient Name | Miss G SHRIYA | Contact No | 9903531379 |
| Address | 102 R B SARANI | Age | 13 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||