Patient Intake & Registration

Create a new Master Record for patient management and clinical tracking.

Full Legal Name

Date of Birth

Gender

Aadhaar / National ID

Contact Number

Address

account_balance_wallet

Self-Pay

Standard hospital rates apply.

security

Private Insurance

TPA & Corporate panels.

gavel

Government Scheme

Social health initiatives.

TPA Provider

Government Scheme

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Upload ID Card

Aadhaar, PAN, or Passport (PDF/JPG)

medical_information

Health Card

Insurance or Scheme Card (PDF/JPG)