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Type of Patient
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Private
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Personal Information
Title
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Mr.
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Title Prefix
First Name
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Middle Name
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Gender
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Blood Group
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AB+
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CNIC / Passport
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CNIC No
Passport No
CNIC No
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Other CNIC
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Passport No
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Date of Birth
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Age
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Years
Months
Days
Password
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Reference ID
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Contact Information
Country
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Afghanistan
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State/Province
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City
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Address
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Mobile No
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Telephone No
Email
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Occupation
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Government Employee
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Next of Kin
First Name
Last Name
Relation
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Father
Mother
Brother
Sister
Son
Daughter
Spouse
CNIC No
Mobile No