Asiri Central Hospital - Norris Canal Road-Colombo 10
Dr. SAMPATH WITHANAWASAM
Cardiologist
Special Notes:
.NO CANCELLATION, TRANSFER OR REFUND WITHOUT DR`S PERMISSION ( morning sessions only )
May 1, 2024
Wed 07:00 am
Patient No.
03
Holiday
COMPLETE WITHIN
Nationality
Local
Foreign
Country
Sri Lanka
Maldives
Other
India
Dubai
Malaysia
China
England
Australia
Brazil
France
Japan
Pakistan
Bangladesh
USA
Canada
Indonesia
Italy
New Zealand
Qatar
Russia
Singapore
Thailand
Seychelles
Kuwait
Madagascar
Lebanon
Nepal
Mauritius
Myanmar
Oman
UAE
Patient's Name
Mr.
Mrs.
Mast.
Miss.
Dr.
Dr (Ms.)
Dr (Mrs.)
Prof.
Prof (Ms.)
Prof (Mrs.)
Rev.
Baby
Sis.
Ms.
Hon.
Rev. Sr.
Ven.
Rev. Fr.
Phone
+94
Other
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NIC
Passport
E-mail
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Address
Home
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