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Name Of Hospital / Nursing Home (হাসপাতালের নাম / নার্সিং হোমের নাম)
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Patient Name (রোগীর নাম)
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Patient Gender (লিঙ্গ)
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Male (পুরুষ)
Female (মহিলা)
Others (অন্যান্য)
Patient Registration No. (রোগীর রেজিস্ট্রেশন নম্বর)
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Patient Bed No. (রোগীর বেড় নম্বর)
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Blood Group (রক্তের গ্রুপ)
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A+
A-
B+
B-
AB+
AB-
O+
O-
রোগীর রক্তের গ্রুপ
Mobile Number (মোবাইল নম্বর)
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Email (ইমেল)
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T&C
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