Registration For Doctors / Patients

Type *

Upload Certificate * (Maximum file upload size 25mb)

Logo

(Maximum file upload size 25MB)

Upload Signature (Maximum file upload size 25mb)

Qualification *

Clinic Pics

(Maximum file upload size 25mb)

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Clinic Timing

TO

(press ctrl key and select for multiple selection)

TO

By appointment only

Patient Inspection Time

Diagnosis

Treatment

Charges

Upload Certificate * (Maximum file upload size 25mb)

Category1*

(Enter 10 digit cell no.)

Category2*

No. of Consulting Rooms *

Qualification *

Pharmacy name *

Clinic name *

No. of Consulting Rooms *

Clinic name *

First Name *

Last Name *

ISD Code *

Mobile No. *

ISD Code *

Mobile No. *

Regn. No.

Email *

Gender *

Date Of Birth *

Address *

Pin Code *

City *

State *

Country

GST Number

Password *

Confirm Password *

Membership	Doctor Indian	Subscription	Tax	Total
	Annual membership	1200	216	1416
	Annual membership + SMS	2000	360	2360

Membership	Doctor	Total
	Annual Membership	30 US$

Membership	Medical Student	Subscription	Tax	Total
	Annual membership	1000	180	1180

Membership	Medical Student	Total
	Annual Membership	25 US$

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eSynapse

Digital platform offering bouquet of services for Healthcare partners like Doctors, Patients, Pharmacies and Pathology Labs. By creating an account you’ll have 24/7 access to a wide range of information to help you take an active role in your Practice / health care.

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