<%@ Page Language="C#" AutoEventWireup="true" CodeFile="Register_Hospital.aspx.cs" Inherits="Register_Hospital" %> <%@ Register Assembly="System.Web.Extensions, Version=1.0.61025.0, Culture=neutral, PublicKeyToken=31bf3856ad364e35" Namespace="System.Web.UI" TagPrefix="asp" %> <%@ Register Assembly="AjaxControlToolkit" Namespace="AjaxControlToolkit" TagPrefix="cc1"%> CITIZEN FORCE FOUNDATION FOR CITIZENS

Hospital Registration


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Your Hospital Name & Address, Services, Specialities available, Name of the On-duty Doctor, Contact Number and Availability Times etc.,
will be displayed in "Services->Hospitals->Hospitals In My Area" by default.
If you do not wish to display the same BUT requires only personal protection under Citizen Category please UNCHECK the box here.
YOU CAN EDIT FROM TIME TO TIME THE INFORMATION PROVIDED HERE IN CERTAIN FIELDS AT ANY TIME THROUGH "LOGIN"
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Use dedicated Mobile for Hosiptal Registration(do not use your Personal Mobile as it will prevent your registration in your personal category)
 
Pincode* :
State* :
Session Expires by
 seconds.  
District* :
Mandal / Taluk* :
Post Office Name* :
City / Town / Village * :
Name of the Hospital* :
Dedicated Mobile number (This will be your Login ID and to receive/retrieve forgot password)* : (Password will be sent to this mobile)
Conform Mobile number* :
Email address* :
Confirm Email address* :
Upload Photo :
Name of the Contact Person* :
Designation* :
Mobile Number* :
Email* :
Form Filled By* :
    Privacy statement 
Security Code* :
Enter Security Code* :
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