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Doctor Empanelment Form

Your Expertise, our Care – together for better health

1

General Info

2

Contact Details

3

Speciality & Credentials

4

Work Info

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UnderGraduate (UG) Credentials*

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Willing to Participate in our centre ?

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Willing for Tele Medicine Consultation ?

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Willing to participate in Promotional Activity ?

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Willing to participate in Guest Lecture ?

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