Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. & Time Position Full Name (as per PMDC registration) *Gender *MaleFemaleOtherPMDC Registration Number *Profile Photo * Click or drag a file to this area to upload. Professional DetailsSpecialization *CardiologistInterventional CardiologistCardiac SurgeonOtherQualifications (with institute & year) *Experience (in years) *Current Hospital / Clinic Affiliation(s) *Designation / Position *Days Available *MonTueWedThuFriSatSunPractice City *Available Time Slots *Consultation Type *OnlineIn-PersonBothContact InformationMobile Number (WhatsApp) *Email Address *Banking / Payment DetailsBank NameAccount TitleAccount Number / IBANBranch CodePayment Method *--- Select Choice ---WeeklyMonthlyService & Commission AgreementConsultation Fee (Online) RsClinic Consultation Fee (if applicable) RsDocument UploadsPMDC Certificate * Click or drag a file to this area to upload. CNIC Front & Back * Click or drag files to this area to upload. You can upload up to 2 files. Consent & Declaration *I confirm that all the above information is true and accurate.I agree to abide by the terms, policies, and commission structure of dilkadoctor.pkI authorize dilkadoctor.pk to display my profile and contact details for online appointment bookings.Submit
