Modhupur Road, Jamalpur. | Phone : 01314-868020
| Patient's Name | : Ekramul |
|---|---|
| Patient's Age | : 25 Years |
| Patient's Gender | : পুরুষ |
| F/H's Name | : |
| Mobile | : 01782912191 |
| Address | : shoreishabari |
| Date of Admission | : 04-08-2026 |
| Under Treatment | : |
| Name of Disease | : |
| Cabin / Ward No | : 205 |
(Signature on Behalf of patient)
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