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Diagnostic Empanelment Form

"Stronger healthcare through trusted partnerships."

1

General Info

2

Contact Details

3

Company Overview

4

Other Details

Udyog Aadhar

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GST Certificate

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Upload PAN Card

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POC - Point of Contact

Branch Office (Optional)

Company Profile

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Do you provide home sample collection services for patients?

YES

No

Do you provide doorstep report delivery?

YES

No

*Are you Willing to Collaborate with sms24hrs ?

YES

No