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Book Appointment

Book an appointment at Dr Agarwals Eye Hospitals by filling the form below. Our representative will get back to you at the earliest.


Patient's Full Name
Patient's Email ID

If you would like to have a digital copy of your receipt or reports, please input your primary email ID.

Please input your primary mobile number so that our representative can contact you to confirm your appointment.

Patient’s Mobile Number
Hospital
Date
Time Slot
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Reports (optional)

Upload

Sharing reports from previous appointments will help the doctor give you a more accurate diagnosis.


Maximum of 5 files can be uploaded and it needs to be in PDF format and should not exceed 5mb per file.

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