Birat Medical Center Pvt Ltd
Dharan-8, Sunsari
984-2340666,
info@biratmedicalcenter.com
;
Appointment
Personal Information
Branch
*
Select Branch
Birat Medical Center Pvt Ltd
Patient Type
*
Select Patient Type
New Patient
Old Patient
Patient Id
*
Mobile Number
*
First Name
*
Middle Name
Last Name
*
Age
*
Yrs
Months
Days
Date of Birth
*
Date Of Birth (BS)
Gender
*
Select Gender
Male
Female
Other
Email
Mobile No
*
Appointment Information
Complain
Appointment Type
*
Select One
Registration Type
*
Select One
Department
*
Select One
Doctor
*
Select One
Appointment Date
*
Appointment Slab
Select Appointment Slab
Registration Fee:
Rs.
0
Tax
Rate
Amount
Make Appointment
