Hospital Registration
Hospital Name
Registration Number
Category
Panel
Non-Panel
Contact Person
Designation
Phone
Landline
Email
Login Password
Used to sign in to the Patient Panel after approval.
Confirm Password
Hospital Type
Select
Government
Private
Trust
Charitable
Establishment Year
City
District
State
PIN Code
License Document
Address
Medical Facilities Available
General Medicine
General Surgery
Orthopaedics
Gynecology & Obstetrics
Pediatrics
Cardiology
ICU/NICU
Emergency (24x7)
Diagnostic Lab
Pharmacy
Ambulance
Documents Attached
Hospital Registration Certificate
PAN Card Copy
GST Certificate
NABH/NABL Certificate
List of Doctors & Specialities
Bank Details (Cancelled Cheque/Passbook Copy)
Discount Facility (MoU Section 7)
Consultation Discount %
Tests Discount %
Hospital Services Discount %
Medicines Discount %
Surgery Discount %
Foundation Commission %
Fixed by the foundation — not editable.
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