Suwasevana Hospital - Kandy
Dr. D.M.C.L.B. BOPITIYA
Orthopaedic Surgeon
Special Notes:
PLEASE NOTE THAT THE CONSULTATION FEES WILL BE COLLECTED AT THE HOSPITAL.
May 10, 2024
Fri 06:00 pm
Patient No.
01
Contact Hospital
COMPLETE WITHIN
Nationality
Local
Foreign
Country
Sri Lanka
Maldives
Other
India
Dubai
Malaysia
China
England
Australia
Brazil
France
Japan
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Bangladesh
USA
Canada
Indonesia
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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
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