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Emergency Contact
Emergency Contact
Senok Emergency Response
0773-647828
0770-700116
Other Emergency Response
0773-186726
0718-142669
The details, designed to SAVE YOU TIME...
Full Name of Patient
Passport details
Altering physician name and contact number
Receiving facility, physician name and contact number (on client Request)
Any travelling companion, if so their full name and passport details
Current history and physical notes, test results, medications
Luggage is limited to two small hand carrier
Only One Companion can travel on board
Payment Method (Credit Card or Insurance)
What hospital to transfer
Indemnity form signed
The Indemnity form
Terms & conditions
Brochure
Online Submission
DETAILS OF THE PATIENT
FULL NAME OF THE PATIENT
PASSPORT NUMBER
PHONE NUMBER 01
INFORMATION ABOUT PATIENTS CONDITION
AGE OF THE PATIENT
NATIONALITY
PHONE NUMBER 2
ADDITIONAL INFORMATION
Where To Get
PICKUP LOCATION
WHEN
Where To Drop
DROP LOCATION
WHEN
Insurance
INSURANCE COMPANY
INSURANCE CONTACT NAME
INSURANCE NO
INSURANCE CONTACT PHONE
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