Metrocity Hospital Pvt. Ltd.
Srijana Chowk, Pokhara, Nepal
Proceed To Pay Now
×
Appointment ID :
Online Appointment Form (बहिरङ्ग सेवा दर्ता फारम)
PATIENT DETAILS
First Name (पहिलो नाम) *
Middle Name (बीचको नाम)
Last Name (थर) *
District (जिल्ला) *
Municipality/Rural muni. (नगर/गाउँपालिका) *
Ward No (वडा नं) *
Tole (टोल) *
Phone Number (फोन नम्बर) *
Your Email Address (इ-मेल ठेगाना)
Gender (लिङ्ग) *
Male
Female
Other
Nationality (राष्ट्रीयता) *
Nepali
SAARC
Foreigner
Country (देश) *
Age(Year)/उमेर(वर्ष) *
SCHEDULE INFORMATION
Appointment Date (मिति) *
Date (AD) (मिति) *
Select Department (विभाग) *
--Choose Department--
Preferred Time (समय) *
Have you been seen at
INF
before? (के तपाईंले पहिले INF मा उपचार गर्नु भएको थियो ?)
Yes (छ)
No (छैन)
Patient ID (if any) [बिरामी दर्ता नम्बर]
Remarks [नोट] (If Any)
Note: Appointment date and time requested would be confirmed back soon.
Proceed
Previous Payment
Reset
