Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01447 | Date 20/12/2018 |
| Token No | SM/19-20/7726 28/11/2019 | Serial | 028 |
| 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 | |||