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Home Visit

Disclaimer : Home visit facility is available only for blood sample. Home Visit charges will not applicable if Test Charges are more than Rs. 500.

Enter Test Or Test Packages Details


Select Test Or Test Package *
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To add more test/test packages, Search from below.
Test / Test Package Name Test Price Delete
Home visit Date*
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Note :
Home Visit charges will be apply according to Area & Numbers of Visit.

1. User Details

Name *
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Email Address *
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Password *
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Contact Number *
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2. Patient Details

Patient Name*
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Age*
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Sex*
Male Female
Home Visit Address *
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Location*
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Area*
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Past Medical History
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Reference number
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3. Billing Details

Same as patient details
Billing Name *
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Email ID *
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Contact No. *
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Billing Address *
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Zip Code *
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City*
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State*
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Country*
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Enter Captcha Code*
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User Email ID *
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Password *
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