Healthcare Facility Registration

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Please provide the healthcare facility name.
Please provide a valid email address.
Please provide a contact number.
Please provide the healthcare facility address.
Please provide the city.
Please provide the state.
Please provide the pincode.
Location is required for your healthcare facility to appear in the "Find Nearby" search results.
Please confirm your location on the map.
Drag the marker to adjust the exact location.
Please provide a description of your healthcare facility.
Please provide the date of establishment.
Please choose a password.
Please confirm your password.
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