Partner Onboarding

Join the One Rupee Clinic network. Once we receive your filled form, our team will contact you shortly.

Fill in your details below — fields marked with * are required.

Hospital / Diagnostic Details

Diagnostic / Hospital Name *

Hospital Photo * Capture a clear photo of the hospital / diagnostic center.

Contact Person

Contact Person Name *

Last Name

Address

Street Address Line 1 *

Street Address Line 2

City *

State / Province *

Postal / Zip Code *

Geolocation *

Allow location access to mark your hospital on the map.

Phone Verification

Phone Number *

Enter OTP *

Rate List & Referral

Upload Rate List * Upload your current price list (PDF, JPG or PNG).

Referral Percentage *

Authorization

Signature *

Your signature will be saved as an image with the form.