Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03819 | Date 17/02/2020 |
| Token No | SM/19-20/8842 24/08/2020 | Serial | 001 |
| Patient Name | Mrs. MANAPATI DEVI | Contact No | 9748376972 |
| Address | RAM SITA LINE | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||