Divine Medical Centre

Fill the required field

Country Applying For

HAP No

Full Name

Email Address

Phone Number

Gender

Date of Birth

Current Indian Address

Street Address

Street Address Line 2

City

State

Zipcode

Country

Country Of Issue

Place of Birth

Visa Category

Address

Street Address

Street Address Line 2

City

State

Zipcode

Hypertension (BP)YesNo

DiabetesYesNo

TattoosYesNo

Any history of Tuberculosis (TB)YesNo

Any history of JaundiceYesNo

SmokingYesNo

Any surgical history

Any medical history

Drugs/Medicines list (if presently taking any)

Covid 19 vaccination certificate/Medicines list (if presently taking any)

Confirm Appointment

DATA ENTRIES LIKE DEMOGRAPHICS IS FOR INTERNAL RECORDS AND E-MEDICAL SYSTEM. MEDICAL HISTORY IS MEANT EXCLUSIVELY FOR E-MEDICAL SYSTEM/MEDICAL RECORDS. ALL DATA IS TREATED CONFIDENTIAL

List of documents to carry and instructions:

Original Passport.
2 Photocopies of first and last page of the passport.
2 Photocopies of vaccination certificate with both dose dates information.
2 Photocopies of IME/UCI/HAP ID/Case No. letter received from embassy as advised during booking.
Carry all existing and previous treatment records of medical and surgical history if any.
Wear lens or spectacle if used for eyesight.
Don’t wear/carry jewelry, costly items and valuables.
Attendants are not allowed inside Med Center (except minor applicant and vulnerable applicant).
Fasting is not required.

Book an Appointment

Please Note that for every applicant a separate form is required

Current Indian Address

Address

Get In Touch

Quick Links

Popular Links

Book an Appointment

Please Note that for every applicant a separate form is required

Appointment Form

Current Indian Address

Address

Select Date and Slot

Confirm Your Appointment

Appointment Instructions

Get In Touch

Quick Links

Popular Links