Patient Registration Patient RegistrationRegister simply and a DawaGate representative will call to help complete your profile.First Name *Last Name *Gender *SelectMaleFemaleDate of Birth *Mobile Number *Please check that your mobile number is correct. DawaGate will use this number to contact you and help complete your profile.Email (optional)Governorate *Select governorateCairoAlexandriaGizaQalyubiaDakahliaSharqiaGharbiaMonufiaBeheiraKafr El SheikhDamiettaPort SaidIsmailiaSuezNorth SinaiSouth SinaiFayoumBeni SuefMinyaAsyutSohagQenaLuxorAswanRed SeaNew ValleyMatrouhCity *Select governorate firstPreferred Contact *SelectPhoneWhatsAppDetailed Address (optional)Please enter your address as clearly as possible. DawaGate may contact you to verify or complete the address details.Common Chronic Conditions (optional) Diabetes High Blood Pressure / Hypertension Thyroid Disease Other None ReportedOther chronic condition (optional)Previous Surgeries (optional)Please mention any previous major surgeries you remember. You can also provide this information later when DawaGate contacts you.I consent to DawaGate contacting me and assisting with completing my profile.Submit Registration
