Appointment Request – Dr. Kalyan Banerjee's Clinic

Patient Information

Case Number *

D-

Patient's Name *

Email *

Contact Number *

Requested Appointment Date *

Patients are hereby instructed that this is only a submission of a request not an assurance of an appointment, until official confirmation is received from the Clinic. Confirmed appointments may be cancelled or changed without intimation to the patient due to emergent situations arising at the practice where the requested doctor may not be available. Patients with a critical illness and emergent cases are requested to allow themselves to be attended to by the first available doctor as the specifically requested doctor may not be immediately available for care.

Location *

Doctor *

Any doctor Dr. Kalyan Banerjee Dr. Kushal Banerjee (first Tuesday of the month) (once every 6–8 weeks) Dr. Pijush Datta Dr. Manisha Sethi (every day except Thursday and Friday) Dr. Kavita Juneja Anand

Appointments for Dr. Kalyan Banerjee are exhausted very quickly. These are usually booked over one month in advance. It is very unlikely that an appointment will be available if the requested date is very close to the current date. Patients are encouraged to request appointments with an available doctor.

Disease Details

Please describe your complaints Maximum 2000 characters

New Patient Information

First Patient Name *

Email *

Gender

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Date of Birth *

Country *

State *

City *

Address *