Patient Registration Form

Personal Details

Residential address

Do You Have ?

Membership Details

Terms And Conditions


We recommend that your password should be at least 6 characters long and should be different from your username.

Your e-mail address and mobile number is really important. We use e-mail/mobile number for communication purposes (appointment notifications, etc). Therefore, We kindly request you to provide valid details to be able to use our services correctly.

All your private data is confidential. We will never sell, exchange or market it in any way. For further information on the responsibilities of both parts, you may refer to us.