Appointment

Patient Name *

Sex *

Male

Female

Age *

Merital Status *

Married

Unmarried

Condition *

New Patient

Old Patient

Preferd Appointment Via *

Video Consultation
(0.00 KWD Session Fees)

Audio Consultation
(50.00 KWD Session Fees)

Email Address *

Whatsapp Number *

Upload Previews Prescription or Report Documents
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Additional Message *

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