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

Country
State
City
Hospital
Date
Doctor
Time Slot
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Reports (optional)

Upload
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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.

Book Appointment