Questions & Answers

Appointment Registration

Appointment Registration

If you would like to register for an appointment, please fill up this form and our Client Support department will call you immediately for availability of the doctor.

 

 

 

Fill in the relevant details below
  Your Full Name * :

 

  Age :
  Sex : Male     Female
  Mobile Number :
  Landline Number :
  Address :
  Department you would like to visit * :
  Date Requested : (mm/dd/yyyy)
  Suggested Timings for appointments * :
  Option 1*:
  Option 2  :
  Option 3  :
  Problems you have :
  Enter the code shown in the image * :  
  ( * ) - Mandatory
 

Note : If there is any urgent request or need for appointment please call Client Support at 04 297 6868.

Please note that your appointment will not be confirmed unless the Client Support department contacts you.