Book Appointment - Dr. Gaurav Jain

📅 Date:

📍 Location:

⚠️

⏰ Choose Time Slot:

👨‍⚕️ Patient Details

📅 Appointment Summary

📅

Date-

⏰

Time-

📍

Location-

👤 Patient Name*

Please enter a valid name (2-100 characters)

🎂 Age*

Please enter a valid age (0-150)

⏳ Unit*

⚧️ Sex*

Please select sex

🏠 Address*

Please enter a valid address (5-500 characters)

📱 Mobile Number*

Enter 10-digit number without +91 or 0

Please enter a valid 10-digit mobile number starting with 6-9

✉️ Email Address*

We'll send appointment confirmation to this email

Please enter a valid email address

📋 Chief Complaints*

Please describe your complaints (5-1000 characters)

👥 Referred By

Optional: Leave blank if not referred

← Back to time slots

✅ Appointment Confirmed!

Your appointment has been successfully booked

ℹ️ Appointment Details

👤

Patient Name-

🎂

Age- -

⚧️

Sex-

📱

Mobile-

✉️

Email-

📅

Date-

⏰

Time-

📍

Location-

🏠

Address-

📋

Complaints-

👥

Referred By-

💳 Payment Information

Regular Fee: ₹800

Pay Only ₹525

Online fee

ℹ️ ₹500 consultation + ₹25 platform and other fees = ₹525

⏰ Payment Link Expires: 15 minutes before your appointment time. Please complete payment early to confirm your booking.

Pay via Google Pay, PhonePe, Paytm, or any UPI app

📲 Pay ₹525 in UPI app

⚠️

❓ Important Information

✅ Please arrive 10 minutes before your scheduled time
✅ Bring any previous medical reports, X-rays, or prescriptions
✅ Confirmation email has been sent to your registered email
✅ You can reschedule by replying to the confirmation email
✅ Payment receipt will be provided during your visit

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Book Your Appointment

📅 Welcome to Dr. Gaurav Jain's Appointment System