Minta temu janji | Mr Vimal K. Vasudeavan | Pembedahan Am | Gleneagles Hospital Penang
Doctor's Appointment
Enquiry
Health Screening Appointment
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1
Butiran Janji Temu*
Sila Pilih Hospital *
Sila Pilih Kepakaran *

(Nyatakan ‘N/A’ jika tidak berkenaan)

Diperlukan
2
Tarikh Temujanji*
Tarikh / Masa Lantikan diperlukan *
3
Slot Masa Pilihan*
Sila pilih Slot Masa Pilihan *
4
Butiran Pesakit
Medan Nama Pesakit diperlukan *
Medan Tarikh Lahir diperlukan *
NRIC / Pasport Diperlukan *
Nombor Perhubungan Diperlukan *
E-mel Diperlukan *

*Dengan menyerahkan borang ini, saya mengakui bahawa data yang diberikan adalah tertakluk kepada Notis Perlindungan Data Peribadi IHH MY

Sila nyatakan pilihan anda. *

Kindly note this is not a confirmed appointment.
Our Gleneagles Customer Service team will contact you to finalize your appointment date & time based on doctor's availability.
Serahkan
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