HTML Slip
Uploaded by
mehjabintamim16HTML Slip
Uploaded by
mehjabintamim16<!
DOCTYPE html>
<html lang="en">
<head>
<script src="https://objectstorage.me-jeddah-1.oraclecloud.com/n/axcv6afvufi6/
b/Rum-JS-Public/o/elastic-apm-rum.umd.min.js"
crossorigin></script>
<script>
elasticApm.init({
serviceName: 'GCC-Frontend',
serverUrl: 'https://apm-lean.acuative-me.com:8200',
environment: 'Production',
})
</script>
<link rel="icon" type="image/x-icon" href="/static/svg/logo-favicon-light.svg">
<!-- Global site tag (gtag.js) - Google Analytics -->
<script async src="https://www.googletagmanager.com/gtag/js?id=UA-146902071-
1"></script>
<script>
window.dataLayer = window.dataLayer || [];
function gtag(){dataLayer.push(arguments);}
gtag('js', new Date());
gtag('config', 'UA-146902071-1');
</script>
<meta charset="UTF-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1"/>
<meta name="viewport" content="width=device-width, initial-scale=1.0, maximum-
scale=1.0">
<title>Wafid | <وافد/title>
<meta name="description" content="Wafid is a program under the umbrella of the
Gulf Health Council that enables individuals bound to work or reside in the GCC to
book their medical check-up appointments.
وافد هو احدى برامج مجلس الصحة الخليجي غرضه توفير مواعيد الفحص الطبي للوافدين
القادمين الى دول مجلس التعاون الخليجي بغرض العمل او الإقامة.">
<meta name="keywords"
content="Wafid, GCC, GHC, Medical center, Gulf Cooperation Council
States, Medical Examinations, health check-up, appointment, medical centers
accreditation, Accreditation status">
<!-- ISO 3166-1-alpha-2 Flags style-->
<link rel="stylesheet" href="/static/country-flags/image_sprite/ip2location-
image-sprite.css">
<link rel="stylesheet" href="https://unpkg.com/leaflet/dist/leaflet.css"
crossorigin=""/>
<link rel="stylesheet"
href="/static/vendor/semantic/dist/semantic.min.css">
<link rel="stylesheet" href="/static/css/semantic-responsive.css">
<!-- Glide.js styles -->
<link rel="stylesheet" href="/static/css/vendor/glide.core.min.css">
<link rel="stylesheet" href="/static/css/vendor/glide.theme.min.css">
<!-- CropperJS styles -->
<link rel="stylesheet" href="/static/css/vendor/cropper.min.css">
<!-- Custom styles -->
<link rel="stylesheet" href="/static/css/main.css">
<link rel="stylesheet" href="/static/css/menu.css">
<link rel="stylesheet" href="/static/css/instant-notifications.css">
<!-- Components -->
<link rel="stylesheet" href="/static/css/components/breadcrumbs.css">
<link rel="stylesheet" href="/static/css/components/cards.css">
<link rel="stylesheet" href="/static/css/components/forms.css">
<link rel="stylesheet" href="/static/css/components/glide.css">
<link rel="stylesheet" href="/static/css/components/menu.css">
<link rel="stylesheet" href="/static/css/components/table.css">
<link rel="stylesheet" href="/static/css/components/message.css">
<link rel="stylesheet" href="/static/css/components/modal.css">
<link rel="stylesheet" href="/static/css/components/icons.css">
<link rel="stylesheet" href="/static/css/components/gcc-slip.css">
<link rel="stylesheet" href="/static/css/components/captcha.css">
<script type="text/javascript">
function printTrigger(elementId) {
var getMyFrame = document.getElementById(elementId);
getMyFrame.focus();
getMyFrame.contentWindow.print();
}
</script>
</head>
<body>
<div class="ui menu basic borderless gcc-menu">
<div class="item">
<a href="/" id="gcc-header-icon-continer" class="header item
brand menu-lsc-fix">
<img class="ui image" src="/static/svg/logo.svg">
</a>
</div>
<div class="ui container">
<div class="ui grid gcc-submenu-wrapper">
<div class="full wide column">
<div class="ui menu stackable gcc-submenu">
<div class="ui container centered gcc-submenu-
continer width-edit">
<a class=" item" href="/">Home</a>
<!---->
<!-- <div class="ui pointing dropdown item None">-->
<!-- GHC accreditation-->
<!-- <i class="dropdown icon"></i>-->
<!-- <div class="menu">-->
<!-- <a class="item"-->
<!-- href="/accreditation/apply/">Apply for accreditation </a>-->
<!-- <a class="item"-->
<!-- href="/accreditation/status/">Check accreditation status</a>-->
<!-- </div>-->
<!-- </div>-->
<!---->
<div class="ui pointing dropdown item None">
Medical Examinations
<i class="dropdown icon"></i>
<div class="menu">
<a class="item"
href="/book-appointment/">Book an Appointment </a>
<a class="item"
href="/search-slip/">Appointment Slips</a>
<a class="item"
href="/medical-status-search/">Medical Examination Result</a>
</div>
</div>
<!--<a class=" item"-->
<!-- href="/medical-status-search/">Health Check-Up</a>-->
<!--<a class=" item"-->
<!-- href="/medical-center/medical-center/">Medical centers</a>-->
<div class="ui pointing dropdown item None">
Medical Centers
<i class="dropdown icon"></i>
<div class="menu">
<a class="item"
href="/medical-center/medical-center/">Wafid Medical Centers
Accreditation</a>
<a class="item"
href="/medical-center/search/">Medical Centers List</a>
</div>
</div>
<a class=" item"
href="/guidelines/">Guidelines</a>
<!---->
<!-- <div class="ui pointing dropdown item None">-->
<!-- Check status-->
<!-- <i class="dropdown icon"></i>-->
<!-- <div class="menu">-->
<!-- <a class="item"-->
<!-- href="/medical-status-search/">Check candidate status</a>-->
<!-- <a class="item"-->
<!-- href="/certificate-search/">Membership certeficate</a>-->
<!-- </div>-->
<!-- </div>-->
<!---->
<a class=" item"
href="/faq/">FAQs</a>
<!--<a class="item" href="/static/pdf/Regulations%20of%20Medical%20Examination%20of
%20Expatriates%20Coming%20to%20GCC%20States%20for%20Work%20or%20Residence.pdf"-->
<!-- target="_blank">Rules and regulations</a>-->
<a class=" item" href="/contact-us/">Contact Us</a>
<a class="item mobile tablet only"
href="/login/">Login</a>
<div class="item support-phone mobile
tablet only">
<img src="/static/svg/headset.svg"
class="support-icon">
<b>
<a href="tel:
+966920023560">+966920023560</a>
</b>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="right menu" style="padding-right: 3%">
<div class="item tablet or lower hidden">
<a class="ui secondary button" id="gcc-header-login-
botton"
href="/login/">Login</a>
</div>
<div class="mobile tablet only right menu menu-icon menu-lsc-
fix">
<button class="button basic" id="menubutton">
<i class="bars icon"></i>
<i class="x icon"></i>
</button>
</div>
</div>
</div>
<main class="">
<div class="ui vertical basic segment slip-search">
<div class="ui container container-dashboard">
<div class="ui fluid card gcc-card">
<div class="content">
<form class="ui form" action="/search-slip/"
method="post">
<input type="hidden" name="csrfmiddlewaretoken"
value="Wbed0o9bIPMGW0ChMl6j8NNlYqhPUYgwlgof3TInuztS9NmgvfitqQz8FucwWXAn">
<div class="form-fields-container">
<h1>Wafid Appointment Slip</h1>
<div class="two fields">
<div class="field " >
<label>
Passport NO
</label>
<input type="text" name="passport" placeholder="Enter Passport
No" maxlength="50" id="id_passport">
</div>
<div class="field " >
<label>
Nationality
</label>
<select name="nationality" id="id_nationality">
<option value="" selected>Select nationality</option>
<option value="1049">Afghan</option>
<option value="2">Albanian</option>
<option value="1012">Algeria</option>
<option value="3">Algerian</option>
<option value="4">American</option>
<option value="5">Andorran</option>
<option value="6">Angolan</option>
<option value="1070">Angolan</option>
<option value="7">Antiguans</option>
<option value="8">Argentinian</option>
<option value="9">Armenian</option>
<option value="10">Australian</option>
<option value="11">Austrian</option>
<option value="12">Azerbaijani</option>
<option value="13">Bahamian</option>
<option value="14">Bahraini</option>
<option value="15">Bangladeshi</option>
<option value="16">Barbadian</option>
<option value="17">Barbudans</option>
<option value="18">Batswana</option>
<option value="19">Belarusian</option>
<option value="20">Belgian</option>
<option value="21">Belizean</option>
<option value="22">Beninese</option>
<option value="23">Bhutanese</option>
<option value="24">Bolivian</option>
<option value="25">Bosnian</option>
<option value="26">Brazilian</option>
<option value="1014">Britain</option>
<option value="27">British</option>
<option value="28">Bruneian</option>
<option value="29">Bulgarian</option>
<option value="1077">Bulgarian</option>
<option value="30">Burkinabe</option>
<option value="31">Burmese</option>
<option value="32">Burundian</option>
<option value="33">Cambodian</option>
<option value="34">Cameroonian</option>
<option value="35">Canadian</option>
<option value="36">Cape Verdean</option>
<option value="37">Central African</option>
<option value="38">Chadian</option>
<option value="39">Chilean</option>
<option value="40">Chinese</option>
<option value="41">Colombian</option>
<option value="42">Comoran</option>
<option value="43">Congolese</option>
<option value="44">Costa Rican</option>
<option value="45">Croatian</option>
<option value="46">Cuban</option>
<option value="1072">Cuban</option>
<option value="47">Cypriot</option>
<option value="48">Czech</option>
<option value="49">Danish</option>
<option value="50">Djibouti</option>
<option value="1050">Dominica</option>
<option value="51">Dominican</option>
<option value="52">Dutch</option>
<option value="53">East Timorese</option>
<option value="54">Ecuadorean</option>
<option value="55">Egyptian</option>
<option value="56">Emirian</option>
<option value="57">Equatorial Guinean</option>
<option value="58">Eritrean</option>
<option value="59">Estonian</option>
<option value="60">Ethiopian</option>
<option value="61">Fijian</option>
<option value="177">Filipino</option>
<option value="63">Finnish</option>
<option value="64">French</option>
<option value="65">Gabonese</option>
<option value="66">Gambian</option>
<option value="67">Georgian</option>
<option value="68">German</option>
<option value="69">Ghanaian</option>
<option value="70">Greek</option>
<option value="71">Grenadian</option>
<option value="72">Guatemalan</option>
<option value="1076">Guatemalan</option>
<option value="73">Guinea-Bissauan</option>
<option value="74">GuineanGuyanese</option>
<option value="1067">Guineense</option>
<option value="75">Haitian</option>
<option value="76">Herzegovinian</option>
<option value="77">Honduran</option>
<option value="78">Hungarian</option>
<option value="79">Icelander</option>
<option value="1">Indian</option>
<option value="81">Indonesian</option>
<option value="82">Iranian</option>
<option value="83">Iraqi</option>
<option value="84">Irish</option>
<option value="85">Israeli</option>
<option value="86">Italian</option>
<option value="87">Ivorian</option>
<option value="88">Jamaican</option>
<option value="89">Japanese</option>
<option value="90">Jordanian</option>
<option value="91">Kazakhstani</option>
<option value="92">Kenyan</option>
<option value="93">Kittian and Nevisian</option>
<option value="180">Kittitian and Nevisian</option>
<option value="193">KOREAN</option>
<option value="94">Kuwaiti</option>
<option value="95">Kyrgyz</option>
<option value="1080">Kyrgyzstani</option>
<option value="96">Laotian</option>
<option value="97">Latvian</option>
<option value="98">Lebanese</option>
<option value="99">Liberian</option>
<option value="100">Libyan</option>
<option value="101">Liechtensteiner</option>
<option value="102">Lithuanian</option>
<option value="103">Luxembourger</option>
<option value="104">Macedonian</option>
<option value="105">Malagasy</option>
<option value="106">Malawian</option>
<option value="1069">Malawian</option>
<option value="1015">Malaysia</option>
<option value="107">Malaysian</option>
<option value="108">Maldivian</option>
<option value="109">Malian</option>
<option value="110">Maltese</option>
<option value="111">Marshallese</option>
<option value="112">Mauritanian</option>
<option value="113">Mauritian</option>
<option value="114">Mexican</option>
<option value="115">Micronesian</option>
<option value="116">Moldovan</option>
<option value="117">Monacan</option>
<option value="118">Mongolian</option>
<option value="1066">Montenegrin</option>
<option value="119">Moroccan</option>
<option value="120">Mosotho</option>
<option value="121">Motswana</option>
<option value="122">Mozambican</option>
<option value="1068">Myanmar</option>
<option value="123">Namibian</option>
<option value="124">Nauruan</option>
<option value="125">Nepalese</option>
<option value="126">Netherlander</option>
<option value="139">New Guinean</option>
<option value="127">New Zealander</option>
<option value="129">Nicaraguan</option>
<option value="130">Nigerian</option>
<option value="1073">Nigerien</option>
<option value="128">Ni-Vanuatu</option>
<option value="131">North Korean</option>
<option value="132">Northern Irish</option>
<option value="133">Norwegian</option>
<option value="134">Omani</option>
<option value="135">Pakistani</option>
<option value="136">Palauan</option>
<option value="1007">palestine</option>
<option value="190">PALESTINIAN</option>
<option value="137">Panamanian</option>
<option value="138">Papua</option>
<option value="187">Papua New Guinean</option>
<option value="140">Paraguayan</option>
<option value="141">Peruvian</option>
<option value="142">Polish</option>
<option value="143">Portuguese</option>
<option value="1064">Portuguese</option>
<option value="144">Qatari</option>
<option value="145">Romanian</option>
<option value="146">Russian</option>
<option value="147">Rwandan</option>
<option value="1071">Rwandan</option>
<option value="1060">Saint Kitts and Nevis</option>
<option value="148">Saudi</option>
<option value="149">Scottish</option>
<option value="1074">Senegalese</option>
<option value="192">SENGALE</option>
<option value="150">Serbian</option>
<option value="1062">Sierra Leonean</option>
<option value="1053">Sierra Leonean</option>
<option value="151">Singaporean</option>
<option value="1079">Slovakian</option>
<option value="1078">Slovenian</option>
<option value="152">Somali</option>
<option value="1011">South Africa</option>
<option value="153">South African</option>
<option value="154">South Korean</option>
<option value="191">SOUTH SUDANESE</option>
<option value="155">Spanish</option>
<option value="156">Sri Lankan</option>
<option value="157">Sudanese</option>
<option value="158">Surinamer</option>
<option value="189">Swedish</option>
<option value="159">Swiss</option>
<option value="160">Syrian</option>
<option value="161">Taiwanese</option>
<option value="162">Tajik</option>
<option value="163">Tanzanian</option>
<option value="164">Thai</option>
<option value="195">Togolese</option>
<option value="196">TRINIDADIAN</option>
<option value="194">Tunisian</option>
<option value="165">Turkish</option>
<option value="1063">Turkmen</option>
<option value="166">Ugandan</option>
<option value="167">Ukrainian</option>
<option value="1013">United states of America</option>
<option value="1045">Unused</option>
<option value="168">Uruguayan</option>
<option value="169">Uzbekistani</option>
<option value="185">Vanuatu</option>
<option value="170">Venezuelan</option>
<option value="171">Vietnamese</option>
<option value="172">YEMENI</option>
<option value="173">Zambian</option>
<option value="174">Zimbabwean</option>
</select>
</div>
</div>
<div class="two fields">
<script
src="https://www.google.com/recaptcha/api.js?render=6LflPAwnAAAAAL2wBGi6tSyGUyj-
xFvftINOR9xp"></script>
<script type="text/javascript">
grecaptcha.ready(function() {
grecaptcha.execute('6LflPAwnAAAAAL2wBGi6tSyGUyj-xFvftINOR9xp', {action:
'form'})
.then(function(token) {
console.log("reCAPTCHA validated for 'data-widget-
uuid=\"6030dba8573540318931b17238c9b8c8\"'. Setting input value...")
var element = document.querySelector('.g-recaptcha[data-widget-
uuid="6030dba8573540318931b17238c9b8c8"]');
element.value = token;
});
});
</script>
<input class="g-recaptcha"
type="hidden"
name="captcha"
required_score="0.6" data-sitekey="6LflPAwnAAAAAL2wBGi6tSyGUyj-xFvftINOR9xp"
id="id_captcha" data-widget-uuid="6030dba8573540318931b17238c9b8c8" data-
callback="onSubmit_6030dba8573540318931b17238c9b8c8" data-size="normal"
>
<div class="right
aligned">
<button type="submit" class="ui primary
large aligned button">Search</button>
</div>
</div>
</div>
</form>
</div>
</div>
</div>
</div>
<div class="mobile hidden">
<div class="ui large modal gcc-modal gcc-slip-modal gcc-slip-web-view">
<i class="close icon"></i>
<div class="header">
<div class="header__logo"><img class="ui image" src="/static/svg/logo-gcc-
slip.svg"></div>
<div class="header__text">Medical Examination Registration
Confirmation</div>
<div class="header__logo"><img class="ui image" src="/static/img/gcc-logo-
white.png"></div>
</div>
<div class="content">
<div class="description">
<table class="ui basic table table--modal stackable slip-table">
<thead>
<tr>
<th colspan="4" class="center aligned"><h3>Medical Examination
Appointment Slip</h3>
</th>
</tr>
</thead>
<tbody>
<tr>
<td class="field_name">Merchant reference №</td>
<td class="field_value">Appointment-91007202573454884-
RnduXdgXS0</td>
</tr>
<tr>
<td class="field_name">GCC Slip №</td>
<td class="field_value">91007202573454884</td>
</tr>
<tr>
<td class="field_name">First name</td>
<td class="field_value">Rasel</td>
<td class="field_name">Nationality</td>
<td class="field_value">Bangladeshi</td>
</tr>
<tr>
<td class="field_name">Last name</td>
<td class="field_value">Khan</td>
<td class="field_name">National ID</td>
<td class="field_value">6780013233</td>
</tr>
<tr>
<td class="field_name">Gender</td>
<td class="field_value">Male</td>
<td class="field_name">Marital status</td>
<td class="field_value">Married</td>
</tr>
<tr>
<td class="field_name">Country traveling to</td>
<td class="field_value">Saudi Arabia</td>
<td class="field_name">Date of Birth</td>
<td class="field_value">12/Dec/1985</td>
</tr>
<tr>
<td class="field_name">Passport №</td>
<td class="field_value">A09004532</td>
<td class="field_name">Passport expiry date</td>
<td class="field_value">1/Jan/2030</td>
</tr>
<tr>
<td class="field_name">Passport issues place</td>
<td class="field_value">Dhaka</td>
<td class="field_name">Passport issue date</td>
<td class="field_value">2/Jan/2025</td>
</tr>
<tr>
<td class="field_name">Applied position</td>
<td class="field_value">Labour</td>
<td class="field_name">Payment status</td>
<td class="field_value">
<i class="icon check circle" style="color: green"></i>PAID
</td>
</tr>
<tr>
<td class="field_name">Amount</td>
<td class="field_value">10 USD</td>
</tr>
</tbody>
</table>
<table class="ui basic table table--modal stackable mc-table">
<thead>
<tr class="center aligned">
<th colspan="4">
<h3>Medical center information</h3>
</th>
</tr>
</thead>
<tbody>
<tr>
<td class="field_value" colspan="2">
Prime Medical Centre</td>
</tr>
<tr>
<td class="field_value" colspan="2">
<i class="map marker alternate icon"></i>
Bangladesh,
Dhaka,
Ka-33/8, Jagonnathpur, Vatara
</td>
</tr>
<tr>
<td class="field_value" colspan="2">
<i class="mobile alternate icon gray"></i>
+8801958239255
</td>
</tr>
<tr>
<td class="field_value" colspan="2">
<i class="envelope icon gray"></i>
<a href="/cdn-cgi/l/email-protection"
class="__cf_email__" data-
cfemail="bececcd7d3dbd3dbdad7dddfd28f88fed9d3dfd7d290ddd1d3">[email protected]
</a>
</td>
</tr>
<tr>
<td class="field_value" colspan="2">
<i class="globe alternate icon table-subtitle"></i>
https://primemedicalcentrebd.com/
</td>
</tr>
<tr class="working-hours">
<td class="field_value" colspan="4">Working hours</td>
</tr>
<tr>
<td class="four wide">Monday</td>
<td class="field_value">
9:00 AM -
5:00 PM
</td>
</tr>
<tr>
<td class="four wide">Tuesday</td>
<td class="field_value">
9:00 AM -
5:00 PM
</td>
</tr>
<tr>
<td class="four wide">Wednesday</td>
<td class="field_value">
9:00 AM -
5:00 PM
</td>
</tr>
<tr>
<td class="four wide">Thursday</td>
<td class="field_value">
9:00 AM -
5:00 PM
</td>
</tr>
<tr>
<td class="four wide">Friday</td>
<td class="field_value">
Closed
</td>
</tr>
<tr>
<td class="four wide">Saturday</td>
<td class="field_value">
9:00 AM -
5:00 PM
</td>
</tr>
<tr>
<td class="four wide">Sunday</td>
<td class="field_value">
9:00 AM -
5:00 PM
</td>
</tr>
<tr class="barcode">
<td class="field_value" colspan="4">
<img src="/get-barcode/RkGA531BLrVn6g1/">
</td>
</tr>
<tr class="slip-dates">
<td class="field_name">Generated data</td>
<td class="field_value slip-dates__generated">10/Jul/2025</td>
<td class="field_value slip-dates__valid_till right aligned"
colspan="2">
<i class="icon info circle blue"></i>
Slip is valid only till 9/Aug/2025
</td>
</tr>
</tbody>
</table>
</div>
</div>
<div class="actions">
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mobile"
style="font-
size: 1rem !important;">Medical Examination Appointment Slip</h3>
</th>
</tr>
<tr>
<td class="field_name center aligned">
Generated data
<div class="field_value center aligned">
10/Jul/2025
</div>
</td>
</tr>
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Slip is valid only till undefined
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<td class="field_name">
Merchant reference №
<div class="field_value">
Appointment-91007202573454884-RnduXdgXS0
</div>
</td>
</tr>
<tr class="tr-mobile">
<td class="field_name">
GCC Slip №
<div class="field_value">
91007202573454884
</div>
</td>
</tr>
</table>
<table class="ui basic table table--modal stackable mc-table">
<tr>
<td class="field_name">First name
<div class="field_value">
Rasel
</div>
</td>
<td></td>
<td></td>
<td></td>
<td class="field_name">
Last name
<div class="field_value">
Khan
</div>
</td>
</tr>
<tr class="tr-mobile">
<td class="field_name">
Nationality
<div class="field_value">
Bangladeshi
</div>
</td>
<td></td>
<td></td>
<td></td>
<td class="field_name" colspan="2">
National ID
<div class="field_value">
6780013233
</div>
</td>
</tr>
<tr class="tr-mobile">
<td class="field_name">
Gender
<div class="field_value">
Male
</div>
</td>
<td></td>
<td></td>
<td></td>
<td class="field_name" colspan="2">
Date of Birth
<div class="field_value">
12/Dec/1985
</div>
</td>
</tr>
<tr class="tr-mobile">
<td class="field_name">
Marital status
<div class="field_value">
Married
</div>
</td>
<td></td>
<td></td>
<td></td>
<td class="field_name" colspan="2">
Country traveling to
<div class="field_value">
Saudi Arabia
</div>
</td>
</tr>
<tr class="tr-mobile">
<td class="field_name">
Passport №
<div class="field_value">
A09004532
</div>
</td>
<td></td>
<td></td>
<td></td>
<td class="field_name" colspan="2">
Passport issues place
<div class="field_value">
Dhaka
</div>
</td>
</tr>
<tr class="tr-mobile">
<td class="field_name">
Passport issue date
<div class="field_value">
2/Jan/2025
</div>
</td>
<td></td>
<td></td>
<td></td>
<td class="field_name" colspan="2">
Passport expiry date
<div class="field_value">
1/Jan/2030
</div>
</td>
</tr>
<tr class="tr-mobile">
<td class="field_name">
Applied position
<div class="field_value">
Labour
</div>
</td>
<td></td>
<td></td>
<td></td>
<td class="field_name" colspan="2">
Amount
<div class="field_value" colspan="2">
10 USD
</div>
</td>
</tr>
<tr>
<td class="field_name">
Payment status
<div class="field_value">
<i class="icon check circle" style="color:
green"></i>PAID
</div>
</td>
</tr>
</table>
</div>
<div style="border: 0.5px solid #cfcfcf; margin-top: 20px;">
<table class="ui basic table table--modal stackable mc-table
custom-mc">
<thead style="display: contents;">
<tr class="center aligned">
<th colspan="4">
<h3 class="header-mobile second-section">Medical center
information</h3>
</th>
</tr>
</thead>
<tbody>
<tr>
<td class="field_name">
Medical Center Name
<div class="field_value">
Prime Medical Centre
</div>
</td>
</tr>
<tr>
<td class="field_name">
Location
<div class="field_value">
Bangladesh,
Dhaka,
Ka-33/8, Jagonnathpur, Vatara
</div>
</td>
</tr>
<tr>
<td class="field_name">
Mobile Number
<div class="field_value">
+8801958239255
</div>
</td>
</tr>
<tr>
<td class="field_name">
Email
<div class="field_value">
<a href="/cdn-cgi/l/email-protection"
class="__cf_email__" data-
cfemail="e9999b80848c848c8d808a8885d8dfa98e84888085c78a8684">[email protected]
</a>
</div>
</td>
</tr>
<tr>
<td class="field_name">
Website
<div class="field_value">
https://primemedicalcentrebd.com/
</div>
</td>
</tr>
</tbody>
</table>
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