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Karthik Clinic & Karthik Ultrasound Scan Centre
MICO Layout, II Stage, Arekere, Bannerghatta Road, Bangalore - 560076


Appointment Request Form

Appointments are available from : 04-06-2020  
 
Please fill in the details below to request for an appointment. We’ll call and confirm (ensure your mobile number is correct). By filling up the form you are requesting for an appointment, which will be confirmed by us over phone. Till you receive our call, this will only be a request and not a confirmed appointment.
 
Patient Name*
May 2020
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Holidays
Gynecologist Name*
Email Id
Phone/Mobile Number*
June 2020
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Holidays
Appointment Request Date* Appointment Date
Timing Slot Morning Afternoon
Noon     Evening
Type of scan*