Clinic Registration

Provide clinic business details and the primary doctor/admin account. After submit, you will complete online payment to activate onboarding.

1. Clinic business identity

Legal and establishment details (GST / tax location).

Clinic legal name *

Clinic type *

Registration / license no. *

Street / building (full address line 1) *

Area / locality (line 2)

City *

State *

Pin code *

Country *

Landline / reception number

2. Primary account holder (admin / doctor)

This person becomes the clinic admin after successful registration payment. Mobile must be unique and is used for sign-in.

First name *

Last name *

Mobile number *

Email address *

Allow any domain, but use a valid email format (example: name@yourclinic.com).

Specialization / degree *

Shown next to the doctor name on prescriptions and records.

Medical council registration no. *

Required for valid digital prescriptions.

3. Registration payment

Annual subscription (excl. GST) ₹3,600.00

GST (18%) ₹648.00

Total to pay ₹4,248.00

Secure online checkout: after submitting this form, you will be redirected to payment checkout (Razorpay). On successful payment, activation email is sent automatically.

I have read and accept the Terms & Conditions.

You must tick the box above to enable Continue to payment.

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