Teleconsultation / Walk in Registration / Advance Appointment "*" indicates required fieldsAppointment Type* Teleconsultation Walk in Registration Advance AppointmentWhatsapp No*Patient Type* New OldHIN Number*Preferred Language*(example : English, Nagamese, Hindi etc)Booking Date* DD slash MM slash YYYY Your Full Name*Age*Please enter a number greater than or equal to 0.Gender*MaleFemaleOthersRelative Name*Relation*HusbandWifeFatherMotherBrotherSisterNephewNeiceAddress* Location City State / Province / Region CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Mobile Number*Departments (Teleconsultation)* Dermatology ENT Medicine Obstetrics & Gynaecology Orthopedics Radiation Therapy / Oncology Pediatrics Surgery Urology Pediatric Surgery CardiologyDepartments (Walk in)* Dermatology ENT Medicine Obstetrics & Gynaecology Orthopedics Pediatrics Radiation Therapy / Oncology Surgery Urology Pediatric Surgery Cardiology Head and Neck Dental Physical Medicine & Rehabilitation Palliative Care Surgical OncologyDepartments (Advance Appointment)* Dermatology ENT Medicine Obstetrics & Gynaecology Orthopedics Pediatrics Surgery Urology Pediatric Surgery Cardiology Head and Neck Physical Medicine & Rehabilitation Palliative Care Surgical OncologyCardiology* Avitso LiegiseHead and Neck* Dr Aby K BabuDental* Dr E Aremo Yanthan Dr Tiapong AmriDermatology* Dr Leishiwon Kumrah Dr Sentila Panger Dr AveniObstetrics and Gynaecology* Dr. Bendangtoshi Jamir Dr. RebekiMedicine* Dr Megongusie Meru Dr Kununggoyi Domeh Dr. Imnanaro Difusa Dr. Nokchur Imchen Dr P C Hmingmuanpuii Dr Rosemary YanthanENT* Dr Clement Momin Dr Lalyang Dr VotoSurgery* Dr Temsula Alinger Dr Jacob Varkey Dr Bona Lotha ShitiriUrology* Dr. Augustine ShitiriPaediatrics* Dr Sulanthung Kikon Dr Tenukala Aier Dr Wonashi TsanglaoOrthopedics* Dr Keith kalyan Ingty Dr Puloto Dr NungdilongRadiation Oncology* Dr Shirley T Leivon Dr Khrutsozo Kikhi Dr. VishalaPediatric Surgery* Dr. SharadhaPhysical Medicine & Rehabilitation* Dr Chinithung Y EzungPalliative Care* Dr Tony Vikas BishwasSurgical Oncology* Dr H Denchu Phom Dr Handilu Kath RengmaNature of Complaint*Nature of Complaint (Advance Appointment)*Teleconsultation* Fees: HiddenNew Appointment (Walk in)* Fees: Old Appointment (Walk in)* Fees: New Appointment (Walk In) Urology* Fees: Old Appointment (Walk In) Urology* Fees: New Appointment (Walk In) Cardiology* Fees: Old Appointment (Walk In) Cardiology* Fees: HiddenNew (Advance Appointment)* Fees: Old (Advance Appointment)* Fees: New Appointment Urology* Fees: Old Appointment Urology* Fees: New Appointment Cardiology* Fees: Old Appointment Cardiology* Fees: Total Fees