Zulekha Hospitals

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Doctor Name*

Appointment Date

Appointment Time*

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Email *

Contact No. *

Please provide correct Contact number and Email Id as we will revert to confirm.

Patient Type*
Self Paying Patient Insurance - Patient

Do you want to stay ahead from the rest ?

Yes No
Extra AED100 is applicable*

Choose *Fast Track Clinic for :

No waiting time
One-on-one assistance
Free Refreshment

Do you want Teleconsultation?

Yes No

Branch *

Department

Doctor Name*

Appointment Date

Appointment Time*

Su	Mo	Tu	We	Th	Fr	Sa
	1	2	3	4	5	6
7	8	9	10	11	12	13
14	15	16	17	18	19	20
21	22	23	24	25	26	27
28	29	30	31

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Please provide correct Contact number and Email Id as we will revert to confirm.

Do you want to stay ahead from the rest ?

Choose *Fast Track Clinic for :

Do you want Teleconsultation ?

Please provide correct Contact number and Email Id as we will revert to confirm.

Do you want to stay ahead from the rest ?

Choose *Fast Track Clinic for :

Do you want Teleconsultation?

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