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+ 1 541-754-3010

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+ 1 541-754-3010

Online Forms

Here are some important forms you to review and complete prior to your appointment with one of our physicians or provider.

  • Screening Checklist for Visitors
  • New Patient Enrollment Form
  • Medical History Form
  • Online Doctor Appointment Form
  • Psychiatric Evaluation Form
  • Quick Emergency Contact Form
  • Blood Donation Form
  • HIPAA Privacy Restriction Questionnaire
  • Medical Release Form

We are a family centered practice that incorporates compassion and dedication to promote your well being.

+91 8593 900 095

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Kallingal-Puthanathani, Malappuram, 676551
Phone Number: +91 8593 900 095
E-Mail: Info@primushospital.in

Address:

Kallingal – Manjachola Rd, Puthanathani, Kerala 676551

Phone:

+91 +91 8593 900 095

Opening Hours:

Mo-Fr: 07:00-23:00h

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+91 8593 900 095

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Kallingal-Puthanathani, Malappuram, 676551

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