Ziqitza Health Care

Kindly fill up the form given below to register for the 108 Emergency Ambulance Services:

Hospital Name :

District :

City :

Address :

Phone Number :

Email :

24 hours Emergency Services

Yes

Clinic	Maternity Home	Nursing	Polyclinic	Hospital
Medical College	Diagnostic Center	Blood Bank	Others

Please Specify :

System :

Allopathic	Ayurvedic
Homeopathic	Others

Please Specify :

Types Of Services Available :

OPD Indoor Diagnostic Blood Bank All

1. Accident & Multiple Trauma

Yes No

2. Head Injuries

Yes No

3. Cardiac Emergencies

Yes No

4. Respiratory Emergencies

Yes No

5. Poisoning, Snake, Insect and Animal Bite

Yes No

6. Industrial Accidents and Poisoning

Yes No

7. Burns Emergencies

Yes No

8. Obstetric Emergencies

Yes No

9. Pediatric Emergencies

Yes No


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