Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00640 | Date 23/08/2018 |
| Token No | SM/19-20/17819 08/02/2020 | Serial | 040 Last Visit: 04/08/2022 |
| Patient Name | Mr. GOBINDA PATRA | Contact No | 9331557379 |
| Address | 21, CHATRA BAJAR ROAD | Age | 78 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||