You are on page 1of 4
~\ Ispahani Islamia Eye Institute and Hospital Z,¢y Bangladesh The Laeger od Olde SaclSTE PRN OORS Soreiaa BAO earn EEN ON FORM an B25IUCS ratntename: MD Wola Avsheren ae: bt (Clinical Record : Sooke {Sree ene te EE A FR SP EC RE TT FRET SO ee SP OEE HST STH A AACE * CR ST THY EN AE EN EN... e 8 CATA NO EE SPT CUTE RTE FRET Bere 8 34 CN Se, TR, aa mT RT NTE HT TET S| 1 coe of eer PR 2 ie or ea cece SI Taga Ohl 5 Bnd Pane, 92 98 S535, eb wwe arr or opoitmant: 09630896553 Cornea Clinic \ (9: Foe (i /20xv Cae ni ry FI ae SL OR ee 2 pose (D) Eppousor of 200 POM clas L Le nae \ ) ispahani istamia Eye Institute and Hospital Bangladesh The Largest and Oldest multispecialty Eye Hospital iw Bangladesh art sereerre craniere earn atient Record [ENS Name: Dateie Om ial econ (DIVA Present History: PastOuular History: Meaical History Hen) cardiac] om C] thycos ] asthma other etait Family Histon ee comer oN Tae i= O [ADVICE/PRESCRIPTION: WHEN TO RETURN: fale. Pet ate REFERRAL To: iC) Phoygimn © Lee ELE ae Baa ia

You might also like