Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00643 | Date 23/08/2018 |
| Token No | SM/19-20/2345 08/05/2019 | Serial | 036 Last Visit: 08/12/2025 |
| Patient Name | Mr. GOBINDA ADAK | Contact No | 9143002319 |
| Address | 93, A.P GHOSH ROAD CHATRA | Age | 76 Years,11 Months,6 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||