Instructions

Fill out all required fields marked with an asterisk (*). All fields are now mandatory.
Enter your hospital registration number in the "Registration Number" field.
After registration, you will receive a printable bill receipt.
Bring the printed receipt with you to the hospital.
All ultrasound investigations at DMCH are provided free of charge.
Requisition form upload is mandatory for all patients.
Indoor patients should also upload a treatment chart photo if available.
Outdoor patients should upload prescription photo if available.

Register Patient

Complete the form below to register for ultrasound investigation

Personal Information

Date

Registration Number

Full Name

Age

Gender

Male

Female

Other

C/O

Mobile Number

Aadhar Number

Address

Patient Type

Indoor (IPD)

Outdoor (OPD)

Department

Doctor

Unit

Investigation(s)

Whole Abdomen

Lower Abdomen

Lower Abdomen & Fetal Wll-Being

Remarks