Category: Uncategorized

  • NMC Specialty Hospital, Abu Dhabi

     

    Hospital/Clinic Information

    Name NMC Specialty Hospital, Abu Dhabi
    Address
    Zayed the First St., Near Sama Tower, Madinat Zayed, P.O. Box: 6222, Abu Dhabi, United Arab Emirates
    Phone +971 2 633 2255
    Working Hours 24 Hours
    Emergency Available Yes

     

    Specialties:

    • Dentist
    • Family Physician
    • Gastroenterologist
    • General Practitioner
    • General Surgeon
    • Internist
    • Neurologist
    • Obstetrician-Gynecologist
    • Ophthalmologist
    • Orthopedist
    • Pediatrician
    • Urologist

    Description:

     

    Founded: 1975

    Type: Multi Speciality

    Launched in 1975, NMC Specialty Hospital Abu Dhabi is a multi-specialty hospital supplying trusted and quality health care services to those of Abu Dhabi and the neighboring area. The clinic is affiliated with major federal in addition to global insurance businesses and enjoys immediate billing centers together with the insurance companies and third-party administrators (TPA).

    In NMC Healthcare we guarantee excellent care, genuine consideration, and also a true commitment to the total wellbeing of society. We feel that healthcare is not really about detecting, diagnosing, notifying, or treating someone however it’s all about helping people to contribute a nutritious and healthful life. We’re dedicated to serving the communities in which we do business and also vow to supply our clients with the expected Hope of a Happy and Healthy Life.

    As the saying goes,’ The journey of one million miles begins with one measure’, ” our unbelievable travel began with your very first measure in 1974, once we first found a tiny clinic and pharmacy at Abu Dhabi under the name New clinic (NMC).

    Doctors:

    Dr. Aaia Mohamed Taha Salih
    General Practitioner
    Dr. Ahmed Mohamed Hassan
    Medical Practitioner
    Dr. Ahmed Mohsen Ahmed Ameen
    Specialist Dermatologist and Venereologist
    Dr. Ali Iyoob Valiyaveettil
    Specialist Gastrointestinal and Laparoscopic Surgeon
    Dr. Amir Ali
    Consultant Urologist
    Dr. Ananth Pai Kalsank
    HOD & Specialist – General Surgery
    Dr. Anantha Guruswamy
    Specialist Neurologist
    Dr. Anup John Thomas
    Specialist Paediatrician & Neonatologist
    Dr. Arun Mohan
    Specialist Internal Medicine
    Dr. Arun Thattunkal Korah
    Specialist Gastroenterologist
    Dr. Asha Suresh Prakash
    Specialist Internal Medicine
    Dr. Ashok Kumar Karki
    Specialist Radiology
    Dr. Ashok Kumar Pareek
    Specialist Paediatrics
    Dr. Ashwin Avadhani
    Specialist Orthopaedics
    Mr. Aston Banatlao
    Physiotherapist
    Dr. Balaji Balasubramaniam
    Consultant Surgical Oncologist
    Dr. Bejoy Peethambaran
    Specialist Dermatology & Venereology
    Dr. Bhesham Kumar
    General Practitioner
    Dr. Binu Sasidharan Neelakantan
    Specialist Orthopaedic Surgery
    Dr. Biraj Naithani Panchal
    Consultant Plastic Surgeon
    Dr. Bobby Sebastian
    Specialist Psychiatry
    Dr. Cherian Thampy
    Specialist Medical Oncologist
    Dr. David George Rigonan Cheu
    General Practitioner
    Dr. Debasis H Biswas
    Specialist Nenonatologist
    Dr. Deepa Puthukkot
    General Practitioner
    Dr. Dhanaraja Padubidri Devadiga
    General Practitioner
    Dr. Dharmendra Bhyleshwar Chaturvedi
    Dr. Dinesh Kumar Dhanwal
    HOD & Consultant Endocrinology
    Dr. Dinesh Subhash Baviskar
    Specialist Radiology
    Ms. Divya Lawrence
    Physiotherapist
    Dr. Gururaja Sharma
    Specialist Radiologist
    Dr. H Sadashiva Somayaji
    Specialist Orthopaedician
    Dr. Hala Emam Mohamed Gandya
    General Practitioner
    Dr. Hameed Yazir
    General Practitioner – Dentist
    Dr. Hanan Elmorshedi
    Specialist Paediatrist
    Dr. Ibrahim Mohamed Badran
    Specialist Paediatrics

    Dr. Ibrahim Siam
    Consultant Endocrinology
    Dr. Iram Nasir
    Specialist General Surgery
    Dr. Jagadeesha Maharudraiah
    HOD & Specialist Clinical Pathologist
    Dr. Jay Anto Kalliath
    HOD & Specialist Ophthalmology

    Gallery:

  • Al Noor Hospital Abu Dhabi | Appointments | Contact | Doctors

    Al Noor Hospital Abu Dhabi | Appointments | Contact | Doctors

    Hospital/Clinic Information

    Name Al Noor Hospital Abu Dhabi
    Address
    Al Mutmmani Street, next to Fatima Zahra Mosque Abu Dhabi – United Arab Emirates
    Phone +9718002000
    Working Hours 24 Hours
    Emergency Available Yes
    Website Al Noor Hospital
    Location on Map

    Founded: 1985

    About Hospital:

    At Mediclinic Al Noor Hospital in Abu Dhabi, we are passionate about our patient treatment with humanity, explanation and listening. Al Noor Hospital takes every precision steps to collect quality results from the patient. At Al Noor Hospital team of medical professionals gives accurate attention to each patient. Doctors at Al Noor Clinic brings immense experience and knowledge to the UAE Community.

    The international standard facility is designed to keep the comfort, convenience and relaxation of the patient at best. The philosophy of giving accurate treatment to patients of Al Noor Hospital is our core value.

    Specialities:

     

    Out-Patient and inPatient Services

    • Audiology and Cochlear Implant
    • Cardiology
    • Dentistry
    • Dermatology
    • Ear, Nose and Throat (ENT)
    • Emergency Medicine
    • Endocrinology / Diabetes
    • Family Medicine
    • Gastroenterology
    • GP
    • General Surgery
    • Haematology
    • Internal Medicine
    • Nephrology
    • Neonatology
    • Neurology
    • Neurosurgery
    • Obstetrics and Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Paediatric Cardiology, Surgery, Neurology, Gastroenterology, Dentistry
    • Physiotherapy
    • Plastic surgery
    • Psychiatry
    • Pulmonology & Respiratory Diseases
    • Radiology
    • Rheumatology
    • Urology
    • Vascular Surgery

    Type: Multi Speciality

    Doctors:

    Get More details about doctors 

    Abdelhadi Abdelgabbar Abdelhadi Dr.
    Specialities
    Neonatology

    Abdulla Aljneibi Dr.
    Specialities
    Paediatric Endocrinology

    Abir El Sayed Ahmed Dr.
    Specialities
    Dermatology

    Aguida Ventura Perez Dr.
    Specialities
    Internal Medicine

    Ahmad M. Adnan Ghazal Dr.
    Specialities
    Obstetrics and Gynaecology

    Ahmed Abdullmajeed Mohammad Dr.
    Specialities
    General Practice

    Ahmed Fekry Sakr Dr.
    Specialities
    Emergency Medicine

    Ahmed Fouad El Sayed Ali Dr.
    Specialities
    Neurosurgery

    Ahmed Hamouda Arnaout Dr.
    Specialities
    Internal Medicine

    Ahmed Muammer Mhd Hamza Alirksusi Dr.
    Specialities
    Paediatrics

     

    Gallery:

    al-noor-hospital-abu-dhabi al-noor-hospital-abu-dhabi al-noor-hospital-abu-dhabi

  • Oman Insurance Company

    Oman Insurance Company

    Company Profile:

    Website www.omaninsurance.ae
    Industry Insurance
    Company Size 200 to 400 Employees
    Founded 1975
    Based in Dubai, UAE
    Company Type Public Company

    One of the largest insurance providers in the UAE with over 830,000+ customers. Started in 1975 Oman insurance becomes a leading insurance company with 45 years of experience in the UAE insurance industry. Our Core Values are Collaboration, Customer First, Excellence, Integrity, Constant Improvement.

    Oman Insurance Company always considers as a standard for other companies because of the excellent commitment to its customers. Oman Insurance secured A Excellent rating from AM best. Also won Mena Insurance Awards 2020, Best Insurance Company UAE, and Best Motor Insurance Company in UAE 2020 from Global Brand Awards.

    Due to the stability and Quality of Services, Standard & Poor recognized Oman Insurance as an A-Stable Company. Long Term Relationship, Customer-Centric Packages, one focus priority make Oman Insurance one of the most recognized and Rewarded insurance players in the MENA region.

    Insurance Services:

    Oman Insurance has diversified categories of Insurance Services that includes:

    • Life Insurance
    • Motor Insurance
    • Health Insurance

    Dedicated packages for Large and Small Scale Industries

    • Construction
    • Marine
    • Energy

    Life Insurance:

    Oman life insurance has feature life affordable premium on each product, fast and quick claim without hassles, Covering all kinds of life insurance needs.

    Life insurance Plans:

    • Online Plans
    • Whole Life Plan
    • Unit Link
    • Term Insurance
    • Diabetic Care Insurance

    Motor Insurance:

    Living in Dubai and not owning a car is less likely. Oman insurance 100,000+ customers enjoy motor car insurance with A Graded Garage Network, Fully Automated Claim, Online Insurance, Competitive and affodable rates.

    Motor Insurance Plans:

    • Oman Insurance Comprehensive Car Insurance
    • 3rd Party Car Insurance
    • Tesla Car Insurance
    • High Net Worth Cover

    Health Insurance:

    DHA makes insurance mandatory for all UAE citizens you can find no one in the country without health insurance. With more than 83,000 individuals insured with Oman insurance, getting affordable insurance plans supports a wide network of hospitals from all around the UAE.

    DHA Essential Benefits Plan

     

    Life at Oman Insurance Company:

    If you chose Oman Insurance Company for work you will find that Oman Insurance Company believes in individual skills and experiences which are true meaning for the company. Oman Insurance work environment is diverse, dynamic, and supports exiting work culture. The work culture generates many opportunities which helps in defining the future and fast track your career. To give Training and knowledge to the newly joined Oman insurance has established an academy.

    Oman Insurance Company Jobs:

    For the latest Job Openings and opportunities visit Oman Insurance Careers page.

    Contact:

    Bur Dubai:

    Corporate Office,  Al Rumaithy Building
    Al Mankhool Area Kuwait Street
    Opposite Aster Maternity Hospital Bur Dubai, P.O. Box 31546
    Dubai, United Arab Emirates

    Phone:
    +971 4 703 1000
    Fax:
    +971 4 398 1987
    service@omaninsurance.ae

     

     

  • Perfect Smile Dental Clinic Dentist Appointments

    Perfect Smile Dental Clinic Dentist Appointments

    Hospital/Clinic Information

    Name Perfect Smile Dental Clinic Dentist
    Address
    203, Second floor, Adidas Bldg, Al dhabi tower, Hamdan St, Abu Dhabi, UAE
    Phone +971 2 633 4660
    Working Hours Mon to Sat: 9:00Am to 9:30PM

    Fri: 1:30 PM to 9:30 PM

    Emergency Available No
    Dentist Appointment Book Online

    Specialties:

    • Dentist
    • Childrens Dental Treatment
    • Cosmetic Dentistry
    • Crown/ Bridge/ Prosthodontic treatments
    • Family Dental
    • Hollywood Make Smileover
    • Orthodontic / Braces Treatment
    • Root canal Treatments/ Endodontic treatments
    • Teeth Cleaning and Polishing
    • Teeth Whitening
    • Tooth Implants
    • All Routine Dental Treatment

    Description:

    The Dental Clinic is here to make your Smile Perfect, Located in Abu Dhabi City right in a central location easily accessible to residents. Perfect smile uses State of the art Dental equipment with affordability as a key for successful operations.

    Type: Dentistry

    Doctors:

    • Specialist Orthodontist: Dr. Bharani Kumar Reddy
    • Dentist: Dr.Y.Swapna
    • Dentist & Impantologist: Dr. Ajay Pala
    • Dentist: Dr. Madhuri Priya

    Gallery:

  • Central Private Hospital- Get Appointment from Doctors in UAE

    Central Private Hospital- Get Appointment from Doctors in UAE

    Hospital/Clinic Information

    Name Central Private Hospital
    Address
    Sheikh Zayed St,Mysaloon Near Clock Tower – Opp Fatima Al Zahrah Mosque Sharjah – UAE
    Phone +97165639900
    Working Hours 24 Hours
    Emergency Service Available

    Specialties:

    • Dentist
    • Family Physician
    • Gastroenterologist
    • General Practitioner
    • General Surgeon
    • Internist
    • Neurologist
    • Obstetrician-Gynecologist
    • Ophthalmologist
    • Orthopedist
    • Pediatrician
    • Urologist

    Description:

    Founded: 1980

    Type: Multi Speciality

    One of the oldest hospitals in the Sharjah Region, serving happy citizens as well as foreigners for more than 40 years. Dr. Shakir Vali started his career in UAE in 1975 and in 1980 he started a small venture a Polyclinic in Sharjah, with time polyclinic is expanded, In 2002 Dr. Shakir Vali prospered the Polyclinic into a 60-bed Hospital.

    Central Private Hospital is now a multi-specialty Hospital including all types of medical specialties and highly educated medical staff. Central Private Hospital strives to give excellent international quality medical care to citizens at affordable prices. Patients come from various counties mostly expats, which has been treated by the hospital’s multilingual and multi-ethnic medical staff and doctors.

    Doctors:

    • Dr.Irfan Rehman
      Orthopedist
    • Dr.Mustafa Akbarali Kutiyanawala
      General Surgeon
    • Dr.Waleedkhalid Al Qaysi
      Gastroenterologist
    • Dr.Yaqub Hayati
      Internist
    • Dr.Ala Bibi Karishma
      Family Physician
    • Dr.Amnah Maqsud
      Pediatrician
    • Dr.Ahmed Fathi Nasef
      Pediatrician
    • Dr.Ali Raza Talpur
      General Practitioner
    • Dr.Bhavna Durgaprasad Kumre
      Obstetrician Gynecologist
    • Dr.Chandan Sharda Narsing Das
      General Practitioner
    • Dr.Halah M Ali Ibrahem
      Obstetrician Gynecologist
    • Dr.Waleed Khalid Abdulsattar Al Qaysi
      General Surgeon
    • Hashim Alsafar Zaki
      Internist
    • Jagdish
      Dentist
    • Sourabh
      Cardiologist

    Gallery

  • Oman Insurance Dental Claim Form Download

    Oman Insurance Dental Claim Form Download

    The Oman direct Billing Claim form is not only useful in getting your Claim for dental Treatment but the document is actually the first report of your medical history. The dentist will write significant important details such as what type of diagnosis has been done, tests, x-ray details, extraction, root canal treatment, etc.

    On the Oman Dental Claim form, there is a separate portion of the teeth diagram. The dentist will identify which teeth is treated for that moment and which treatment is performed on those teeth. Your dentist after all assessments make a report and prescribed the best medicines which he writes on the claim form hence you could always remember which medicine is best for you.

    You can Download the Oman Dental Claim form in PDF format print it and give it to the Administrator of the facility

    Oman Dental Claim Form

    In case you need Outpatient Oman Insurance Direct Billing Claim Form to get it from here.

    Oman Dental Claim Form Sections:

    Provider Details:

    This section is to be filled by Administrative personnel or receptionist of that medical facility. Provider details, treating Dentist or Assistant and his Facility license code.

    Member Patient details:

    Here the admin person will find patient details online after seeing your Oman Insurance Card. He might ask patient or patient relative for other details. This section is to be filled by Administrative personnel or receptionist of that medical facility.

    Medical Section:

    Once all other sections are filled, the claim form will be handed over to the Physician or in this case Dentist for filling of Diagnosis and Treatment Details.

    Service Details and Prescribed Medicines:

    In this section, the Dentist will fill out the detailed treatment and tests performed on the patient. As well as which medicines prescribed to the patient at that time.

    Patient Declaration:

    This is the only section to be filled by the Patient in which he writes his name signature and date.

     

     

     

  • Nextcare Insurance Plan Charges

    Nextcare Insurance Plan Charges

    Nextcare insurance provides and manages insurance-related services of their partners and insurance companies. Whenever insuree buys a plan from Nexcare partners listed below their plans are actually managed by Nexcare.

    Nexcare makes innovative plans, idea-oriented approach, analytic support, customer services, financial plans for their clients. Most of these companies are one of the renowned insurance providers from all around MENA region. Nexcare services include Production, Network Management, Preauthorization, Call Center, Claim Processing, Reconciliation, and Customer Services.

    As a leading third-party insurance administrator Nexcare is only able to give prices to the vendors, ordinary customers can only get the price of their respective insurance plans by contacting their insurance companies’ names given below.

    1. Allianz Maroc
    2. Adonis Insurance & Reinsurance Co SAL (ADIR)
    3. Al Mashrek Insurance & Reinsurance sal
    4. Allianz SNA SAL
    5. Amana Insurance Company SAL
    6. Arab Lebanese Insurance Group SAL (ALIG)
    7. Arabia Insurance
    8. Arope Insurance
    9. Assurex Insurance and Reinsurance S.A.L
    10. BERYTUS Insurance & Reinsurance Co. SAL
    11. Solidarity Mutual Fund
    12. Trust Insurance Company SAL
    13. UFA
    14. United Commercial Assurance SAL (UCA)
    15. Adonis Insurance & Reinsurance Co SAL (ADIR)
    16. Al Mashrek Insurance & Reinsurance sal
    17. Allianz SNA SAL
    18. Amana Insurance Company SAL
    19. Arab Lebanese Insurance Group SAL (ALIG)
    20. BERYTUS Insurance & Reinsurance Co. SAL
    21. Burgan Insurance Company S.A.L
    22. CMEEP
    23. Commercial Insurance
    24. Fidelity insurance and Reinsurance CO. S.A.L.
    25. GROUPMED Insurance
    26. Gulf Insurance Group
    27. La Phenicienne
    28. Order of Engineers and Architects Of Beirut
    29. Order of Pharmacists of Lebanon
    30. Arabia Insurance
    31. Arope Insurance
    32. Assurex Insurance and Reinsurance S.A.L
    33. BERYTUS Insurance & Reinsurance Co. SAL
    34. Burgan Insurance Company S.A.L
    35. CMEEP
    36. Commercial Insurance
    37. Fidelity insurance and Reinsurance CO. S.A.L.
    38. GROUPMED Insurance
    39. Gulf Insurance Group
    40. La Phenicienne
    41. Order of Engineers and Architects Of Beirut
    42. Order of Pharmacists of Lebanon
    43. Securité Assurance
    44. Solidarity Mutual Fund
    45. Trust Insurance Company SAL
    46. UFA
    47. United Commercial Assurance SAL (UCA)
    48. Allianz Egypt
    49. GIG – Arab Misr Insurance Group
    50. Misr Insurance Company
    51. Misr Life Insurance Company
    52. Orient Takaful Insurance Company – Egypt
    53. Royal Insurance Company
    54. Tokio Marine Insurance Company
    55. ENAYA Insurance Company
    56. GHAZAL Insurance Company
    57. Gulf Insurance and Reinsurance – Health & Life
    58. Al Khaleej Takaful Group
    59. General Takaful Co
    60. Majid Al Futtaim
    61. Medgulf Takaful – QFC Branch
    62. Qatar General Insurance & Reinsurance Co (S.A.Q.)
    63. Qatar Islamic Insurance Company
    64. SEIB Insurance & Reinsurance Co
    65. Takaful International Company – QFC Branch
    66. BMCE BANCASSURANCE
    67. RMA
    68. SAHAM ASSURANCES
    69. GAT Assurances
    70. Vision Insurance
    71. Zurich Insurance Middle East – Oman
    72. Al Alamiya Cooperative Insurance
    73. Al Sagar Cooperative Insurance CO
    74. Allianz Saudi Fransi Cooperative Insurance Co.
    75. Saudi United Cooperative Insurance CO ( Walaa)
    76. Weqaya Takaful Insurance & Reinsurance Co
    77. Abu Dhabi National Insurance Company
    78. Adamjee Insurance Company Limited
    79. Al Buhairah National Insurance Co.
    80. Lloyd Assurances
    81. Arab Orient Insurance Company
    82. Arabia Insurance
    83. Dhofar Insurance Company (SAOG)
    84. Falcon Insurance
    85. Muscat Life Assurance
    86. Oman Qatar Insurance Co.
    87. Oman United Insurance Co
    88. Takaful Oman Insurance SAOG
    89. The New India Assurance Co. Ltd
    90. Al Dhafra Insurance Co. P.S.C
    91. Al Fujairah National Insurance Co PSC
    92. Al Hilal Takaful Co
    93. Al Ittihad Al Watani GIC
    94. Al Sagr National Insurance Co.
    95. Al Wathba National Insurance Co.
    96. Alliance Insurance Company
    97. Arabia Insurance Company
    98. Arabian Scandinavian Insurance Co
    99. Dubai Islamic Insurance & Reinsurance Co. – AMAN

     

  • ADNIC Reimbursement Claim Form Download

    ADNIC Reimbursement Claim Form Download

    Abu Dhabi National Insurance Company,  ADNIC is, a main multi-line insurance services supplier, has a wide system of branches just as deals and administration focus the nation over. With a devoted group of more than 500 agents, we at ADNIC are focused on giving extensive protection arrangements, to give consolation to its clients.

    How to Fill ADNIC  Claim Form:

    Must read the following instruction before Filling ADNIC Claim Form.

    1. This form needs to be completed by the insured member (Cardholder), only if the provider is not submitting the claim on his behalf.

    2. Please read the form carefully and make sure to complete all pertinent information. ADNIC will not be able to process any incomplete Reimbursement Claim Form that lacks proper documentation.

    3. Use a separate form for each Member.

    4. All the documents including invoices and medical reports should be in either English or Arabic. Documents in other languages must be translated by an official public translator prior to submission.

    5. The following documents to be attached to your duly filled Reimbursement Claim Form. • Copy of Medical insurance card and Emirates ID. • Original itemized bill/invoices (dated) and receipts of payment. • Original prescription for medication given by the treating doctor (except for controlled drugs). The validity of the prescription is limited to 60 days and for controlled drugs limited to 3 days in line with the Department of Health – Abu Dhabi. • Investigation requests/reports like laboratory tests, x-rays, etc.

    Download ADNIC Claim Form

    Complete the form headings by following their instructions:

    1. Please write your name & Medical insurance card number as mentioned in the Card.

    2. Medical Information – Request your treating doctor to fill up brief medical information about your condition and treatment.

    3. Provider Name & Address – Kindly use more than one line if necessary to provide this information about each facility where you were treated.

    4. Bill No. – Please write the serial number/reference number printed on the bill/receipt/invoice for each service separately.

    5. Service Date – State date of treatment for each service against each bill.

    6. Description of services – State type of service like consultation/Pharmacy/Investigations/Physiotherapy/Dental/ Hospitalization.

    7. Amount – State the exact amount as appears on the invoices.

    8. Total – Total amount of all the invoices submitted with this form for reimbursement from ADNIC. 9. Currency – Name of the currency in which actual payment was made. 10. If treatment is due to a road traffic accident,, a police report is required to be submitted with this form. 11. Declaration: Kindly write your name, signature, date, contact number, and relationship to the cardholder.

  • Download Noor Takaful Reimbursement form

    Download Noor Takaful Reimbursement form

    Please complete this form in BLOCK letters using blue or black ink. Any unclear instructions will not be performed. Countersign all changes or corrections you make.
    Takaful certificate no.
    Claim no.

    • I/We, the undersigned hereby
    • Residing at PO Box no.
    • Emirate/City, covered by
    • Noor Takaful Certificate no. , herby
    • Declare that we have received from the said company the sum of AED representing the amount of indemnity due to me/us in respect of the accident/loss which took place
    • DD / MM / YYYY at (time)
    • DETAILS OF INDEMNITY
    • Being full and final settlement agreed for the repair of TP/participant.

    Download Noor Takaful Reimbursement form

    Download Discharge of Claim

    How to Fill Reimbursement form

    • Full and complete Medical Report/Diagnosis/Discharge summary.
    • from the treating doctor (signed and stamped).
    • Original itemized invoices and receipts for the amount claimed.
    • with Paid Stamp (invoice must show cost per service).
    • Copies of results of diagnostic tests.
    • Copies of the prescriptions.

    Note: For treatment within UAE, please submit your claim within 60 days from the date of treatment. For treatment
    outside UAE, the claim must be submitted within 90 days from the date of treatment.

    To be completed by the cardholder
    Card holder’s name
    Card no.
    Expiry date DD / MM / YYYY Effective date DD / MM / YYYY
    Telephone no.
    Mobile no.
    To be completed by the treating Physician
    Dear Doctor, the beneficiary participating in the medical Takaful
    Program is consulting you for medical care and kindly requests you
    to complete this form.

    Date of onset of symptoms
    If hospitalized Date of admission DD / MM / YYYY
    Discharge date DD / MM / YYYY
    Case management Actual costs