Referring Patients

Referring patients to the Outpatient clinic

* Only to be completed by doctors.

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Referred by

  • Urgent     Standard

Patient Details

  • Male     Female

Reference to

Reason for Referral*

Clinical Data*

  • Thiqa health scheme
  • Aafiya
  • Daman Health Insurance
  • Abu Dhabi National Insurance Company
  • Allianz
  • Orient Insurance
  • Albuhaira National Insurance Company
  •  Al Khazna Insurance
  • AXA
  • Dubai Insurance