Contact no - Ambulance
+91-20-40707777
+91-20-30717777
Emergency Contact No. - Doctors
healthcare@adityabirla.com
+91-20-30717500-5
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After completing this form, you will receive a temporary Medical Registration Number (MRN).
Please provide this MRN number at the hospital reception & pay  INR100/- (registration charges) to complete the registration.
Personal Information
First Name
Middle Name
Last Name
Gender
Date of Birth
Mobile No.
Email
Address 1
Address 2
City
Pin Code
State
Country
Nationality
Foreign Citizens must also fill the information below.
Passport No.
Passport Expiry
Visa No.
Visa Expiry
For assistance with online registration, please call +91-9881123098 or email corporate.desk@adityabirla.com