Patients Registration Form

Sr.No. Detail Validity Value (RS.)
1. general disease/local area patient 5days/5 sitting 150
2. chronic disease/local area patient 5days/5 sitting 300
3. general disease/other area patient 5days/10 sitting 600
4. chronic disease/other area patient 5days/10 sitting 1000
5. CP patient/local area 1 year 5100
6. CP patient/other area 1 year 6100
7. CP patient/abroad area 1 year 21000
8. wheat allergy/local area 1 year 5100
9. wheat allergy/other area 1 year 6100
10. wheat allergy/abroad area 1 year 21000
11. paralysis patient/local area 6 month 3100
12. paralysis patient/other area 1 year 5100
13. paralysis patient/other area 1 year 6100
14. paralysis patient/abroad area 1 year 21000
15. CAMP BOOKING 200 patient Daily 10 days 21500

Patients Registration Form

    Your-name

    Contact number

    S/o, D/o, W/o

    Date

    Address

    Disease

    Aadhar-Card

    मैं अपनी स्वेच्छा से निरोग जीवन संस्थान (रजि.) में प्राकृतिक चिकित्सा, योग सेवा कार्यो के साथ मानवता की भलाई हेतु

    रुपये का योगदान कर रहा हूँ। मैं

    दिनांक