Report a Birth

 
Doctor Name *
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Hospital Name *
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Hospital Address *
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Patient Name
Invoice No/Date*
Treatment Used *
IUIIVFICSIIMSI
Weight of a Baby *
Any Complication during pregnancy *
Any Complication at the time of babies birth *
Would you like to upload your babies pictures (Parents identification will be anonymous)
Note: Allowed file types are jpg,jpeg,png,zip
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