Online payment - Venkateshwar hospital

Patient Name/Name ^*

UHID No.

Online OPD Tele-Consultation Rs. 1500/-
Online OPD Tele-Consultation Without Registration Rs. 1650/-

Other Amount (min. Rs. 600/-)

Payment for ^*
(applicable for other payment)

Name ^*

Mobile No ^*

Email Id ^*

Address^*

Country ^*

City^*

ZIP/Postal Code ^*