Create Patient Owner Account
Personal Information
Full Name
Email Address
Account Information
Mobile Number (Used as Username)
Password
Confirm Password
Location Information
Division
---------
Barisal
Chittagong
Dhaka
Khulna
Rajshahi
Rangpur
Sylhet
Mymensingh
District
---------
Upazila
---------
Union
---------
Village/Area
Additional Information
Profile Picture
Register
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