TO REQUEST FOR AN ONLINE APPOINTMENT, PLEASE COMPLETE THE FORM BELOW AND CLICK THE “REQUEST” BUTTON.

Your appointment will be confirmed through return e-mail or telephonic communication. Please be informed that this submission of “Request for Appointment” will only be workable after confirmation by our Appointment Centre. Confirmation of an appointment depends upon the availability of doctors at your preferred date and time.

TO MAKE AN APPOINTMENT VIA PHONE, OR FOR FURTHER INFORMATION REGARDING YOUR APPOINTMENT, PLEASE CALL OUR APPOINTMENT CENTRE AT THE FOLLOWING NUMBERS:

Phone: 10678, 09666710678

You must fill the * marked fields to submit your request
Patient's Full Name *
:
Date of Birth *
:
Sex
:
Male Female
Mobile *
:
Email *
:
Request for *
:
Specialty for consultation *
:
Doctor *
:
Preferred Date and Time for Appointment
:
Date *
:
 
Time *
:
 
UHID(if any)
:
Spam check *
:
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