Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03819 | Date 17/02/2020 |
| Token No | SM/25-26/2959 11/12/2025 | Serial | 007 |
| Patient Name | Mrs. MANAPATI DEVI | Contact No | 9748376972 |
| Address | RAM SITA LINE | Age | 47 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||