Admitted Patient Payment
Consultation Payment
Registration Number(HN):
R
Or Mobile Number :
Please Update your demography
Name
Father Name
Mother Name
Date Of Birth(DD/MM/YYYY)
Phone
Blood Group
Select Blood Group
A+
A-
B+
B-
AB+
AB-
O+
O-
Address
Gender
Select Gender
Male
Female
Others
Update & Proceed To Payment
Merchant :
Consultation Fee for
Online Charge : 0%
Net Payable Amount:
Description :
Approve URL :
Cancelled URL :
declined URL :
I agree with the
Terms & Conditions
PAY BILL