Elektroniczny system kart pacjentów

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If you have problems with registration, please contact us by phone: +48 730 597 597

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Name

Surname

Street

House number

City

Postcode

Personal identity nr.:

Passport number

Birthday

Gender

Female

Male

Phone

Profession

Language

Country

E-mail

Login The login must be 5 to 40 characters long. It can only consist of numbers (0-9) and letters of the English alphabet (a-z) and the characters: ".-_@", cannot consist only of numbers

Password The password must consist of at least 6 characters. It must contain at least one uppercase letter, one lowercase letter and one number.

Repeat password

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Do you want to enter your invoice details?

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I agree to the Payment Policy for Irrevocable Medical Services, Information clause of the RODO IMC, Information clause RODO clinic dr Preeti Agrawal Regulations for the provision of electronic services by the Dr Preeti Agrawal Clinic