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DIFmnnbcv

The document is a Doctor Information Form inviting healthcare professionals to join a platform aimed at enhancing their visibility and increasing patient footfall. By filling out the form, doctors can create a professional profile that connects them with potential patients and improves their online presence. The form requests essential details such as name, qualifications, specialty, consultation fees, and contact information.

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nishantrawat.ilumina
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22 views2 pages

DIFmnnbcv

The document is a Doctor Information Form inviting healthcare professionals to join a platform aimed at enhancing their visibility and increasing patient footfall. By filling out the form, doctors can create a professional profile that connects them with potential patients and improves their online presence. The form requests essential details such as name, qualifications, specialty, consultation fees, and contact information.

Uploaded by

nishantrawat.ilumina
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Doctor Information Form

We are excited to invite you to join our healthcare platform, designed to enhance

 Your professional visibility


 Increase patient footfall to your Clinic/Hospital.

By sharing your details with us, you gain access to

 A larger network of potential patients.


 Improved online presence, and
 Seamless appointment management.

You are requested to kindly fill out the following form to help us create your
professional profile. Our goal is to make sure your expertise reaches
those who need it most.

Name of the Doctor :

Qualification :

Specialty :

Consultation Fees :

Clinic/Hospital Name : / Address

Mobile Number :

Email Address :

Registration Number :

No Year of in Practice :

Availability :
Doctor Sign

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