Registeration for Treatment

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Registeration for Treatment

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Representation
First name/Last name
Gender
- Male
- Female
Birthday
Date Format: MM slash DD slash YYYY
Age
Origin Country
Marital Status
- Single
- Marriage
Passport Expiry Date
Date Format: MM slash DD slash YYYY
Passport Number
Job
Phone Number
Landline Phone
Email
Social Media

Title of the disease
Description of the disease
Medical records
If you know your vaccination history before entering Iran, specify it
- Typhoid
- Rabies
- Tetanus
- BCG
- Mumps
- Yellow fever
- Hepatitis A
- Hepatitis B
- Pertussis
- Black cough
- Chicken pox
- Polio
- Diphtheria
- Rubella
If you have specific symptoms, please let me know
- Headache
- Blood vomiting
- Body or muscle pain
- Caught
- Stomach or abdominal pain
- Bone fracture
- Fever
- Red skin spot
- Skin scarring
- sore throat
- Weakness and lethargy
- Shortness of breath
- diarrhea
- Inflation of the legs or hands
- blurred vision
- Hair loss
- Redness or swelling of the joints
- Weight loss
- Anorexia
- In the wake of a joint
- Rhinorrhea
- Drowsiness or decreased consciousness
Scan and attach your medical records
Photo by therapist
passport picture
Agency code
security code

about us

Dr. Baradaran's laboratory began on two separate floors, 450 meters across Ferdowsi Street, Wise Building in 2002 to protect patients' well-being and health.

contact info

http://dr-baradaran-lab.ir
info@dr-baradaran-lab.ir
+983132240433

address

Address: Hakim Building (next to Refah Bank), Ferdosi St. Felestin Crossroad, Isfahan, Iran

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