Name *  
	
	
	
	
	Email *  
	
	
	Contact Number *  
	
	
	Select Specialist Type *  
	
		- Select Specialist - 
	    Piles, Hemorrhoids, Hydrocele, Hernia 
	    2D Echo, Angiography, Angioplasty, ICU, All Cardiology Services 
	    Maternity Services, Painless Delivery, High Risk Pregnancy 
	    Kidney Stones, Gall Bladder Stones 
	    Peadiatric Surgery 
          Bariatric Surgery 
	    Liposuction 
	    Minimal Access, Laparoscopy & General Surgery 
	    Gynaecology 
	    MTP and Family Planning Services 
	    24x7 Paediatrics, 24x7 Neonatology (NICU, Ventilator, CPAP) 
	    New Born Intensive Care (NICU) 
	    Orthopaedics, Rheumatology, Knee Replacement 
	    Cancer / Tumor Surgeries 
	    Medicine, General Physician 
	    Maggo Fertility and IVF Centre 
	    Radiology (Ultrasound, CT Scan, X-Ray, HSG) 
	    Endocrinology, Diabetes, Thyroid 
	    Urology (URS, PCNL) 
	    Ophthalmology (Cataract) 
	    TKR, THR, ACL Tear, All Types of Fracture 
	    24x7 Laboratory Services 
	    ENT 
	    Hymenoplasty, Vaginoplasty, Breast Implant 
	    Pulmonology & Sleep Disorders 
	    Nephrology, Dialysis 24x7 
	    Neurosurgery 
	    Cosmetic Surgeries, Plastic, Reconstructive, Aesthetic Surgery 
	    Psychiatry 
	    Physiotherapy 
	    Neurology 
	    Dental Department 
	    Rheumatology 
	    Gender Transformation Surgeries 
	    Key Hole Mastectomy, TLH with BSO 
	    Department of Dermatology & Hair Transplant Surgery 
	    Gastroenterology 
	    Varicose Vein 
	 
	
	
       PREFERRED TIME  *  
       
          - Select - 
          7:00AM - 9:00AM(Only for Health Check Appointments) 
          9:00AM - 10:00AM 
          10:00AM - 11:00AM 
          11:00AM - 12:00PM 
          12:00PM - 1:00PM 
          1:00PM - 2:00PM 
          2:00PM - 3:00PM 
          3:00PM - 4:00PM 
          7:00PM - 8:00PM 
        
    
    
       PREFERRED Date *  
       
    
               Select Nationality [Only for international Patient] 
               
                  - Select Your Residence - 
                  India 
                  Bangladesh 
                  Afghanistan 
                  Angola 
                  Australia 
                  Bhutan 
                  Burundi 
                  Cameroon 
                  Canada 
                  China 
                  Congo 
                  Egypt 
                  Ethiopia 
                  Fiji 
                  Germany 
                  Ghana 
                  Indonesia 
                  Iraq 
                  Ivory Coast 
                  Jordan 
                  Kampala 
                  Kenya 
                  Kigali 
                  Kuwait 
                  Liberia 
                  Madagascar 
                  Malaysia 
                  Maldives 
                  Mauritius 
                  Mongolia 
                  Morocco 
                  Mozambiqie 
                  Myanmar 
                  Nepal 
                  Nigeria 
                  Oman 
                  Pakistan 
                  Philipines 
                  Rwanda 
                  Saudi Arabia 
                  Sierra Leone 
                  South Africa 
                  Srilanka 
                  Sudan 
                  Tanzania 
                  UAE 
                  Uganda 
                  UK 
                  US 
                  Uzbekistan 
                  Yemen 
                  Zimbabwe 
                  OTHERS 
                
            
	
	
	
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