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NoDo you have Papilocare ?
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UAE
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E-HOSPITAL MEMBERSHIP ID NUMBER                            ഇ ഹോസ്പിറ്റൽ അംഗത്വ നമ്പർ
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ITEMS REQUIRED AND QUANTITY ആവശ്യമുള്ള സാധനങ്ങൾ / അവയുടെ അളവ്
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PAY SERVICE CHARGE സേവന ഫീസ്
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UPLOAD PRESCRIPTION ഡോക്ടർ കുറിപ്പടി കൂട്ടി ചേർക്കുക
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PAYMENT - INDIA
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PAYMENT UAE - COMMERCIAL BANK OF DUBAIAL QUSAIS BRANCHACCOUNT NUMBER1002389052IBAN NUMBERAE 390230000001002389052
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NAME OF THE PERSON FILLED THE FORM ഫോം പൂരിപ്പിച്ച ആളുടെ പേരും ഫോൺ നമ്പറും
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NAME OF PATIENT AND PHONE NUMBER. MEDICINES OTHER THAN OVER THE COUNTER ONES REQUIRE PRESCRIPTION. രോഗിയുടെ പേരും ഫോൺ നമ്പറും. ഓവർ കൌണ്ടർ അല്ലാത്ത എല്ലാ മരുന്നുകൾക്കും ഡോക്ടറുടെ കുറിപ്പടി  ആവശ്യമാണ്.
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NAME OF DOCTOR ഡോക്ടറുടെ പേര്
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DATE തീയതി
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