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If you need an appointment with Dr Krishna Raman, we need to know if your complaint falls in the area of his specialty. Please fill in the form below. If approved, you can book your appointment on the web.

Kindly Note: We do not encourage patients living abroad to consult us. You may contact us for further clarifications.


 
First Name:*
Last Name:*
DOB:* Age:  Gender:*
Residential Address:*
Area:* City:*
State:* Country:*
Mobile No.* Occupation:*
      * Using words like business, employed, employee, government servant, Service and Other general terms will auto reject your appointment.
Email:* Confirm Email:*
Nature of problem:* Duration of problem :*
List any surgery done:* List drug allergies if any:*
Are you on any medication?*
1.         2. (If yes, Bring that list when you visit us.)
Treatment given:*
1. 2. 3. 4.
Current status of pain:*
1. 2. 3. 4.
List any other ailment:*
1. 2. 3. 4. 5.
6. 7.
Investigation *
1.  
4.
2.
5.
3.
(Doppler, ultrasound , Bone scan etc.)
6.    
 
 
Verification Code:*
(Letters are not case-sensitive)
               
                    
Our office is not responsible for any omission of details in your form that you fill. So please be careful in filling the same.