Institution Registration

01. Institution Information

Basic identity of the institution.

Institution Name *

Display Name *

Healthcare Sector Category *

Year of Establishment *

Website URL (Optional)

Language *

Country *

Institution Contact Email *

Institution Contact Number *

Business Address *

Institution Logo / Image (Optional)Click to upload logo

Institution Description *

Legal identifiers for compliance.

CIN / Registration Number (Optional)

GST / VAT Number *

Insurance Network ID (Optional)

Medical Council Affiliation *

National Industrial Classification Code (NIC) (Optional)

Regulatory Compliance *

Legally authorized representative.

Full Name *

Designation *

Official Email *

Personal Email (Optional)

Mobile Number *

Address *

Country *

State *

City *

Pincode *

Primary operational point of contact.

Full Name *

Designation *

Official Email *

Personal Email (Optional)

Mobile Number *

Please upload any proofs you have (PDF, JPG, PNG — max 4MB).

Proof of Address (Any) * Proof of Address, Utility Bills, etc.

Registration of Company (Optional) Click to upload company registration

Organization Medical Compliance Certification (Optional) Click to upload medical compliance proof

Legal authorization, data storage & verification consent.