Form Pendaftaran Minat AI

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Form Pendaftaran Minat AI

Silahkan isi identitas Rumah Sakit/Klinik Anda. Kami akan menghubungi via WhatsApp dalam 1-3 hari.

* Indicates required question

Email *

Record my email address with my response

Nama Lengkap *

Your answer

Nama RS/Klinik *

Your answer

Jabatan

Your answer

Nomor Whatsapp

(Pastikan kembali nomor yang dimasukkan sudah benar, Contoh no WA ehealth: 6285777779926)

*

Your answer

email

(Pastikan kembali email yang dimasukkan sudah benar)

Your answer

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