Admission Application Form - Akhtar Hospital

Name

Last Name

Mobile Number

Whatsapp or Telegram Number

Enter your passport number

Date of Birthday

Choose Gender

Male

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Email

Upload your medical documents

Description

Please explain to the doctor a little about the symptoms of your illness and problem so that the treatment process can be done more precisely

Have you visited Shahid Beheshti University of Medical Sciences before?

Yes

No

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