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Doctor Tele-Consultation
Booking Form
FAQ
Package/Service Option
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Please select one
Cardiologist (RM 150.00)
General Consultation (Physician/Internal Medicine) - Adult (RM 150.00)
Medical Officer (MO) - Adult (RM 20.00)
General Surgery - Adult (RM 150.00)
Dermatologist (RM 150.00)
Orthopaedic Surgeon (RM 150.00)
Appointment date & time
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Patient Status
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New
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MR No.:
Name (as per MyKAD/Passport)
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Birth date
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:
MyKAD/Passport
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Gender
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:
Male
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e-mail Address
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Mobile No.
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Tel No.:
Nationality
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Address
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:
Postcode
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Occupation
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Next-of-kin Name
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Next-of-kin Contact No.
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Company Name:
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