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Email*

We’ll use this email for account activation and login.

Username*

Username must be unique and contain only letters, numbers, and underscores.

Password*

Must be at least 8 characters long and include letters, numbers, and special characters.

Organization Name*

Full name of your Hospital.

Tagline*

A brief phrase that describes your Hospital (optional).

Organization Logo*

Upload a square logo image (optional).

Description*

Short description of your Hospital’s mission or services.

Phone Number*

Your Hospital’s contact number.

Country*

State

City

Address*

Physical or mailing address.

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