Pre -registration for Manarom Hospital
Manarom Hospital has set up an on-line pre-registration to speed up new patient's registration process. You can choose to receive the registration form by downloading the form from this website or by fax. Please select the method most convenient to you.
                                                              
Method No.1 : Download the pre- registration form
1.1) Download the registration form    
1.2) Fill in the form
1.3) On the date of your appointment , please give the completed
       form and the following document(s ) to our registration officer.

       -  For Adult : Identity card or  Government service Identity card
       -  For Child and Adolescents : Birth certificate  or  Identity card

Method No.2 : Requesting for the pre-registration form by fax
2.1) Please enter your fax number and the form will be faxed to you
        within 24 hours.
  Your Fax No. :
  Enter the characters you see  :
   
2.2) Fill in the form
2.3) On the date of your appointment , please give the completed
        form and the following document(s) to our registration officer .
        -  For Adult: Identity card or Government service Identity card
        -  For Child and Adolescents: Birth certificate or Identity card

***  Please contact our registration department at 02-7259595
        02-7259592
if you do not receive our pre-registration form
        after 24 hours .