Active Smart Cards


Total Hospitalisation Cases


as on date: 31/03/16
Online Hospital Empanelment Request

Note: Fields marked with * are mandatory
Hospital Name  *  
Hospital Short Name  *  
Hospital Type  *
Location  *  
Sub Category *  
Floor Area (Sq. Ft) 
Hospital Address  *  
State *
District  *  
Sub-District *  
City(Village/Town) *  
PIN Code  *  
Name of Hospital Incharge  *  
Hospital Incharge Mobile No.  *  
Hospital Incharge
Phone No
e.g. 0120-345701
Hospital Incharge
Email ID  *
Name of Owner  
Mobile No. of Owner 
Email ID of Owner   
Latitude  e.g. 09.563200  
Longitude  e.g. 72.893200  
NABH Accredition  
Clinical Registration No.
PAN No.* e.g. ABCDE1234H    
PAN Card Holder's Name
Service Tax
Registration No.
e.g. ABCDE1234HST001
Bank Name *  
Branch Address *  
Bank Account No.*  
IFSC Code *  
Payee Name
No. of Full Time Physicians  *  
Pharmacy *  
Human Resource
Full Time Consultants  *  
Part Time Consultants *  
Visiting Consultants  *  
Duty Doctors  *  
General Nurses  *  
Total No. of Beds
General  *  
Day Care  *  
ICU  *  
ICCU  *  
HDU  *  
InPatient Facilities
No. of Major OTs *  
No. of Minor OTs *    
Cath Lab Facility
Medical Specialties

Surgical Specialties

Medical Super Specialties

Other Specilities

Surgical Super Specialties


Support Services

Infrastructure & Support

Standards on Basic Services

Enter text shown on the image

   Terms and Conditions     Privacy Policy     National Portal     Ministry of Health & Family Welfare