Imperial Healthcare - Kynsey Place, Colombo 07
Prof. SURANJITH SENEVIRATNE
Allergy And Immunology
Special Notes:
ALL APPOINTMENTS WILL BE VIA WHATSAPP. (VIDEO OR AUDIO CALL) FOR FURTHER DETAILS PLEASE CALL 0117555422 / 0775555422. NO Refund, NO Cancelations & NO Transfers.
December 15, 2020
Tue 01:45 pm
Patient No.
05
#05
-
2:45 PM
Session Full
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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