Patient Registration Patient Registration Tailor made Select your tour Fill in this form and tell us what you want. ---PersonTravel Agency Basic Information Basic details of the trip Tour Details Special intrests Health / MedicalCultureDesertAdventureNomadTrekkingCity SightseeingMountainHorse ridingShoppingFoodSporttransferCIPAll Medical Services HospitalDoctorclinicAmbulanceAir ambulanceNurseEmergency Care Accommodation 2 Star Hotel3 Star Hotel4 Star Hotel5 Star HotelApartment HotelLocal HouseCamp Guide LocalSpecialistGuide / Driver Means of connection How did you hear about us? Search engineFriends and FamiliesSocial MediaExhibitionEmailOther visa form Information Sex ---MaleFemale Birth Passport Visa We need the file of your passport, and also if you have traveled to Iran before the scan of your visa is needed too. The size of your passport should be as below: - Size 40kb - Format should be JPEG or GIF - Size should be 5.5cm * 4.3cm - It should be digital Your File Last Visa Scan Patient Registration final Please enter your information How did you get to know Iran Medical Care company? Information request form the patient Have you ever been treated of your illness or problem? YesNo If you know your vaccination history before you arrive in Iran, please specify PolioDiphtheriaRubellaMumpsYellow feverHepatitis AHepatitis BNone of themBlack coughChicken poxB C GTyphoidRabiesTetanus If you have any symptoms please specify Blood vomitingStomach or abdominal painFeverblurred visionRedness or swelling of the jointsAnorexiaBody or muscle paincaughShortness of breathInflation of the legs or handshair lossNone of themheadacheSkin scarringWeakness and lethargydiarrheaRhinorrheaBone fractureRed skin spotsore throatLoss WeightIn the wake of a joint