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Hospital Registration
COVID-19 Hospital Registration
*Hospital Name
Provide Hospital Name
*Address
Provide Address
Select Zone
West Zone
Central Zone
North Zone
East Zone - A
East Zone - B
South Zone
South West Zone
South East Zone
Select Zone
*Contact Person Name
Provide Contact Person Name
*Phone
Provide Phone No
Enter valid Phone 10 digit number
Alternate Phone
Enter valid Phone 10 digit number
*Total No of Covid Beds
Provide Total No of Bed
Enter valid No of Bed
Ventilator (BI-PAP) Facility ?
*Username
Provide Username
*Password
Provide Password
Submit