Broadway
Senior Consultant - Urology
Qualification: |
MBBS | MS (General Surgery) | MCH (Urology) |
Book an appointment for Consultation
Doctor Consultation Charges (Hospital Visit) - Rs. NA/-
Doctor Consultation Charges (Video Consultation) - Rs. NA/-
After you have submitted the appointment request, we might call to confirm the preferred appointment slot.
Doctor Consultation Charges (Prime Consultation) - Rs. NA/-
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Note :Temporary visitor restriction, only one attendant is permitted with the patient. Your cooperation is solicited.
Your Appointment will be confirmed after generating Pre Registration ID and making payment for consultation now.
Patient Registration Details
1
Basic Details
Other Details
Declaration
Manipal Hospital Broadway
Patient Registration Details
Basic Details
2
Other Details
Declaration
Manipal Hospital Broadway
Patient Registration Details
Basic Details
Other Details
3
Declaration
I, the undersigned, declare that the above information provided by me are true to the best of my knowledge and hereby provide my consent to the Manipal Hospital to provide Medical Care, Treatment, Conduct Investigations and Diagnostic Procedures necessary for the above mentioned individual by Medical Staff at Manipal Hospital. I, also understand that Manipal Hospital will not be responsible for any loss, damage or theft of any Personal Property/Belongings of Me/Patient/Visitors within the Hospital Premises. Including Patients rooms and Parking area. I agree to follow all the rules and regulations of Hospital and clear all the expenses incurred for My/Patient treatment on time as per the Terms and Conditions of Manipal Hospital,
If consent provided on behalf of the patient.
I hereby give my consent and authorize Manipal Hospitals to process, store,use,disclose my personal or sensitive information/data collected as per Manipal Privacy Policy
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UHID
Patient Name
Doctor Name
Appointment Date & Time
Mode of Consultation
Location
Mobile Number
Email ID
Consultation Charges
Video
Rs. NA/-
manipal-hospital-admin
yB9TUej1l42I9WVM1SxLXHugckDp6lf3
Pre Registration ID
Patient Name
Doctor Name
Appointment Date & Time
Mode of Consultation
Location
Mobile Number
Email ID
Registration Charges
Consultation Charges
Total Amount Payable
Video
manipal-hospital-admin
yB9TUej1l42I9WVM1SxLXHugckDp6lf3
To continue, re-enter your Registered Mobile Number or Generate Pre Registration ID and make payment for the Doctor Appointment.
To continue, re-enter your Register or Generate Pre Registration ID and make payment for the Doctor Appointment.
1) Up to 4 hrs of appointment time:
Rescheduling of doctor appointment can be done within a week from the date of appointment as per doctor / slot availability.
Cancellation can be done with full refund of the payment.
2) Up to 2 hrs of appointment time:
Rescheduling of doctor appointment can be done within a week from the date of appointment as per doctor / slot availability.
Cancellation of appointment and refund with a cancellation charge of Rs.100/-.
3) Less than 2 hrs of appointment time:
Rescheduling / cancellation of appointment cannot be done, payment non-refundable in this case. However, Units can have the discretion to refund / reschedule in case of exigencies.
Please note : While making the payment online, above mentioned payment terms and conditions should be agreed upon by customers, by clicking in a box ( I agree) and then proceed for payment.
Telemedicine involves the use of electronic communications to enable Hospitals/health care centres to provide healthcare services at different locations through exchange of information and for the purpose of improving patient care. I, confirm that I have received the necessary information to sign this form and I agree to take part in a live telemedicine/teleconsultation session with Manipal Hospitals.
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