Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04458 | Date 08/06/2021 |
| Token No | SM/25-26/6094 28/10/2026 | Serial | 014 |
| Patient Name | Mrs. GUDDI DEBI | Contact No | 7278220735 |
| Address | 8 ram sita lane | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||