Dr. Tahmid
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Personal Information
Full Name
Age
Sex
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Weight (kg) - Optional
Mobile Number
WhatsApp number is same as Mobile
WhatsApp Number
Appointment Details
Appointment Type
Physical Visit (Hospital/Chamber)
Online / Virtual (Home)
Preferred Date
Upcoming Holidays
Preferred Time
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Describe Problem (Optional)
Symptoms / Issues
Payment Information
Virtual appointments require advance payment. Please pay
BDT 300
to
01672928021
via
Bkash
or
pay to bank account
MD. MOSTASIM TAHMID
20501800204076216
Islami bank, Bagerhat Branch
Payment Method
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Bkash
Bank Transfer
Transaction ID / Number
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