Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Lab Center Name *Owner / Director Name *Type of Facility *Diagnostic CenterHospital LaboratoryIndependent Pathology LabRadiology / Imaging CenterYear Established *Registration / License Number (if any)Affiliated Hospitals / Clinics (if any)Contact DetailsPrimary Contact Person *Designation *Email Address *Mobile Number (WhatsApp) *Landline Number (optional)Website (if any)City *Complete Address *Services & Tests OfferedPlease tick all that apply *ECGEchocardiography (ECHO)Exercise Tolerance Test (ETT)CT Coronary AngiographyCardiac MRICardiac Enzymes / Blood TestsLipid ProfileTroponin TestFull Heart Screening PackageExecutive Health CheckupOther TestsUpload your complete test list & pricing (Excel/PDF) * Click or drag files to this area to upload. You can upload up to 3 files. Operational DetailsOpening Hours *Average Daily Test Capacity *Days of Operation *MonTueWedThuFriSatSunHome Sample Collection *YesNoOnline Report Delivery *YesNoPreferred Appointment Notification Method *EmailSMSWhatsApp Layout that Operation Banking & Payment DetailsBank NameAccount TitleEnter Account Number / IBANBranch CodeInvoice Contact Person / Email *Payment FrequencyWeeklyMonthlyDocument UploadsLab License / Registration Certificate * Click or drag a file to this area to upload. Terms & Agreement By registering your lab or diagnostic center with dilkadoctor, you agree to Provide accurate and verified test results. Maintain standard turnaround times and patient confidentiality. Follow ethical medical and data protection practices. Allow dilkadoctor to list your services and manage bookings. Accept the agreed commission and payment terms. *I hereby declare that all information provided is true and accurate.I agree to the platform’s Privacy Policy, Service Agreement, and Commission Terms.Submit
