Upload Prescription Your Name* Mobile Number* Select Ward (Rangpur City Corporation)* Ward 1Ward 2Ward 3Ward 4Ward 5Ward 6Ward 7Ward 8Ward 9Ward 10 Known Area (Select nearest familiar place)* Jahaj Company MorModern MorPairachattarCity BazarLalbagKeraniparaMahiganj BazarMedical MorCantonment RoadStation RoadOther / Not Listed Main Area / Moholla / Road* Remarkable Landmark (Optional) Upload Prescription (jpg, jpeg, png, pdf | max 10MB)*