Join DR. Khokha as a Provider

Personal Information

First Name *

Last Name *

Email Address *

Phone Number *

🇮🇳 +91

Address

City *

State *

Pincode

Country *

Please upload relevant documents to support your application (PDFs, images accepted, max 2MB each):

Documents

Hospital license, accreditations, facility photos

Referral Code Earn HB Coins (Optional)

Optional. If a friend or agent referred you, add their code — both of you will earn HB Coins after approval.

Tell us more about yourself and why you want to join DR. Khokha

I agree to the Terms of Service and Privacy Policy

Cancel

Have questions about the registration process? We're here to help!