Register New Hospital Listing
General Information
Hospital Name
*
Hospital Type
*
-- Select Type --
General Hospital
Specialty Hospital
Multi-Specialty Hospital
Clinic
Diagnostic Center
Other
Website (Optional)
Address
*
City
*
State
*
Pincode
*
Google Maps Link (Optional)
Location Latitude
*
Location Longitude
*
Hospital Contact Information
General Phone Number (10 digits)
*
Emergency Phone Number (Optional)
General Email Address
*
SPOC (Single Point of Contact) Details
This information will be used to generate the Hospital ID and for all official communications.
SPOC Full Name
*
SPOC Designation
*
SPOC Email Address
*
SPOC Phone Number (10 digits)
*
Accreditation & Legal
Registration Number
*
Accreditation Body (Optional)
Accreditation Status/Date (Optional)
License Expiry Date
*
Operational Details
Hospital Working Hours
*
Billing & Payment
Accepts Health Insurance
*
-- Select --
Yes
No
List of Accepted Insurance Providers (Optional)
Payment Methods Accepted
*
Offers & Promotions
Percentage Off by Hospital
*
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