MEDICALCLIC - paiement de prestation et de mis en relation dans le domaine medical
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SOLUTION OF PAYMENT AND IMPLEMENTATION RELATIONSHIP IN THE MEDICAL FIELD

 ..::: ADHESION :::..     Health Centre, please fill out the membership form



  The coordinates of the health center

      Name of the health center * :  Name of the health center  
      Continent * :  Continent  
      Country * :  Country  
      City * :  <= Choose Country  
      Number & street * : The number and street or neighborhood. If you have not, mark no.  
      Zip code * : The zip code. Setting ‘NO’ in case there was not.  
      Neighborhood * : Neighborhood  

  Opening hours

      Open * : de :   à  :(Matin)
et
de :   à  :(Après midi) 		 Opening hours  

  Managers of the health center

      Name of Director * : Name of Director  
      Physician’s Name * : Physician’s Name  
      Website of the health center:
      Contact Email * : Contact Email   Please enter a correct email please  
      Phone number: For the phone, just the values () 0-9   
      Mobile * : Please provide a mobile number of the health center please   For the phone, just the values () 0-9   
      fax: For the fax, just the values () 0-9  


      

 
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