7.

4 Data Collection Sheet:

Department of Community Ophthalmology, BSMMU

Title: “Occupational Exposure to Pterygium patient attending at Eye Outpatient

department in Bangabandhu Sheikh Mujib Medical University Hospital”.

Investigator’s name: Dr. Nazia Ahmed Himi

(A) Particulars of the patient:

PATIENT ID NO:

1. Name

2. Age

3. Address

4. Contact no.

5. Hospital Reg. no

6. Date of examination