Bahmni Lite Enquiry Form

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This enquiry form is only to know more about Bahmni Lite product and it is not a binding for subscription!

Mobile Number *

Secondary Contact Number

Contact Person Name *

Name of Clinic

Type of Clinic?

Single Doctor

Two Doctors

Polyclinic

Day Care

Small Hospital

Other:

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How soon you would like to start?

Immediately

Within a month

Within 3 months

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Do you have ABDM Healthcare Professional ID?

You can register for free at: https://hpr.abdm.gov.in/en

Yes

Clear selection

Is Your Clinic ABDM registered facility?

You can register for free at: https://facility.abdm.gov.in/

Yes

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Submit

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