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PATIENT REGISTRATION

Register to have your hospital number sent to your email within few minutes

Patient Registrationsupport2024-04-18T19:18:23+01:00

Are you a patient residing in the diaspora or a local patient?

Purpose of Registration *

Kindly note that this registration will attract payment of ₦7,500 only.

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Kindly note that this registration will attract payment of ₦23,100 only.

I Agree

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Kindly note that this registration will attract payment of $25 only.

I Agree

Select option.

Full Name *

Enter your full name

Date of Birth *

Enter your date of birth

Gender *

Male

Female

Select Gender

Marital Status *

Single

Married

Separated

Enter your marital status

Address *

Enter your Address

Email *

Enter email address.

Phone *

Enter your phone number

Nationality *

Enter your nationality

State of origin *

Enter state of origin

LGA *

Enter your LGA

Religion

Enter Religion

Genotype *

Others

Not sure

Others (Specify) *

Blood Group *

A+

A-

B+

AB+

AB-

O+

O-

Not sure

Highest Education *

Primary

Secondary

Tertiary

Occupation *

Enter your occupation

Next of kin full name *

Please enter next of kin

Relationship with Next of kin *

Please enter relationship with next of kin

Next of kin phone number *

Please enter next of kin phone number

Department *

Select visiting department

How did you find us? *

Friend

Social Media

HMO/Office

SMS

Website

Others

Others (Specify) *

Submit Form

Thank you !

We have received your registration form.

Registration Date:

You may proceed to book appointment with your temporary EMR Number (TEMP-EMR/).

Kindly note;

Appointment made with this temporary EMR number will be on hold until payment is confirmed.
Permanent EMR number will be sent to your registered email within few minutes after payment confirmation.

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