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Patient Registration

* Fields are required

First Name

Last Name

DOB

Mobile Phone
Patient exists with given Phone Number.

Email Patient exists with given Email.

Gender
Male Female

Province

Provincial Health Number Patient exists with given PHN.

Country

Street

City

Postal Code

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All patients details are deleted permanently by weekly and are not shared or collected for any reason

Mail : support@vistacan.com

Clinic Reception : 2507650544