Appointments Form / अपोइन्टमेन्ट फारम

Full Name / पूरा नाम *

Please enter your full name.

Address / ठेगाना *

Age / उमेर *

Contact Number / सम्पर्क नम्बर *

We will use this number to confirm your appointment.

Email / ईमेल

Your appointment confirmation will be sent to this email.

Specialist Doctors / विशेषज्ञ डाक्टर *

Preferred Date / मिति

Choose a date for your appointment.

Reason for Visit / भेटको कारण

Mention any specific details or symptoms.