Register for Medical Treatment Support in India

Submit patient details and medical reports. Our coordination team will review the information and contact you with the next steps.

Website

Patient Information

Patient full name

Patient name is required.

Age

Gender

District / city

Nationality

Passport status

Contact Person

Guardian/contact person name

Contact person name is required.

Relationship with patient

Phone number

Phone number is required.

WhatsApp number

Enter a valid email.

Medical Information

Treatment category

Urgency level

Current diagnosis

Symptoms / condition summary

Current doctor/hospital in Bangladesh

Current medication, optional

Previous surgery/treatment history

Report Upload

Upload prescriptions, test reports, MRI/CT/X-ray reports, discharge summary, biopsy report, or other documents

Allowed: PDF, JPG, JPEG, PNG, DOC, DOCX. Maximum 10MB per file or 25MB total.

India Treatment Preference

Preferred city

Travel readiness

Preferred hospital, optional

Preferred doctor, optional

Budget range, optional

Support Needed

Doctor appointment

Hospital selection

Cost estimation

Visa invitation support

Travel guidance

Accommodation guidance

Follow-up support

I confirm that the information provided is correct and I agree that Unimarc Health Care Services may use my submitted information and medical documents for healthcare coordination purposes.

Consent is required.