Registration of Private Provider
District *: Taluka *:
UserName *: Select Type :
Name of Pediatrician/Gynecologist *:   MBBS Passing Year *:
Medical College *: GMC Registration No.:
PG Qulification :
Additional Qulification Reg. No.:
Minicipality Reg.No.: Name of Hospital :
Full Address of Health Facility : Bulding Rented or Owned :
No. of Bed Avaliable in Hospital : No of Rooms Avaliable : 
No of Wards Avaliable : Type of Institution :
   
              
Waste Management Agency : Service Avaliable :
Equipments Avaliable : Contact No. :
Fax : E-Mail :