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Healthcare Professionals Registration
Join our network and start providing your healthcare services
Personal Information
Full Name *
Date of Birth
Gender
Select Gender
Male
Female
Other
Contact Details
Email ID *
Phone Number *
Address
City *
State
Pin Code *
Country
Professional Information
Qualification *
Specialisation *
Years of Experience
Certifications
Awards and Recognitions
Work Preferences
Preferred Location *
No. Hours / Month
Cabin Type (Select all that apply) *
Consultation cabin with table and chair set up
Examination cabin with bed
Derma cabin
Dental cabin
Physio cabin
Counselling cabin (sofa set up)
Verification Documents
Photo ID (Driving Licence/PAN Card/Voter ID)
Choose File
PDF, JPG, PNG accepted
Degree Certificate
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PDF, JPG, PNG accepted
Registration Certificate
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PDF, JPG, PNG accepted
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