Feliz Care Service Booking Form Select Patient Gender *MaleFemaleOther Select Starting Time *01AM = 02AM02AM = 03AM03AM = 04AM04AM = 05AM05AM = 06AM06AM = 07AM07AM = 08AM08AM = 09AM09AM = 10AM10AM = 11AM11AM = 12AM12AM = 01PM01PM = 02PM02PM = 03PM03PM = 04PM04PM = 05PM05PM = 06PM06PM = 07PM07PM = 08PM08PM = 09PM09PM = 10PM10PM = 11PM11PM = 12PM00PM = 01AM Select Purpose of Visit *Medical Check-upHospital VisitDoctor VisitOthers * All Fields are mandatory Select Patient Gender *MaleFemaleOther Select Booking Date * (dd/mm/yyyy) Select Starting Time *01AM = 02AM02AM = 03AM03AM = 04AM04AM = 05AM05AM = 06AM06AM = 07AM07AM = 08AM08AM = 09AM09AM = 10AM10AM = 11AM11AM = 12AM12AM = 01PM01PM = 02PM02PM = 03PM03PM = 04PM04PM = 05PM05PM = 06PM06PM = 07PM07PM = 08PM08PM = 09PM09PM = 10PM10PM = 11PM11PM = 12PM00PM = 01AM Select Purpose of Visit *Medical Check-upHospital VisitDoctor VisitOthers * All Fields are mandatory OTP Login Login with OTP Send OTP
