Strict Regulatory Verification & Super Admin Approval

Register Your Healthcare Organization

Hospitals and clinics must register statutory credentials and await explicit Super Admin review and authorization before accessing protected clinical workspaces, staff provisioning, and patient health records.

Organization Identity & Facility Type

Hospital / Medical Center

Multi-department facility with IPD, ICU, OT & OPD

Clinic / Diagnostic Center

Outpatient polyclinic or standalone clinical practice

Organization Display Name *

Registered Legal Entity Name

Ownership Type

Official Organization Email *

Licensing & Regulatory Compliance

Clinical Establishment / License Number *

Issuing Registration Authority

License Registration Date

License Expiry / Renewal Date

Physical Address & Operations

Registered Facility Address *

City *

State *

Postal Code (PIN) *

Official Phone (10-Digit) *

Official Website

24x7 Emergency Contact

Authorized Representative / Medical Director

Representative Full Name *

Official Designation

Representative Official Email *

Representative Mobile (10-Digit) *

Supporting Statutory Credentials & Documents

Clinical Establishment Registration Certificate

clinical_establishment_license.pdf • REGISTRATION_LICENSE

Document Title

Document Type

File Name / Attachment Reference

Mandatory Security Release Gate:Submitting this application does not grant immediate access to hospital workspaces, doctor accounts, or patient health records. The organization remains strictly blocked until an authorized Super Admin independently verifies statutory documentation.