Doctor Registration – Steps 1–3 (Email OTP, Responsive)

Dr Name (periods not allowed)

Don’t use a period (.) in the name.

Invalid character: a period (.) is not allowed.

Mobile Number *

Optional format help: 10 digits starting with 6–9.

Email ID*

You’ll receive a 6-digit OTP at this address.

Please enter a valid email address.

Validation pending

OTP will be sent to your email.

Registered Doctor: — Mobile: —

Gender *

Select a gender.

Experience *

Enter a valid experience.

Referred by

Qualification *

Enter a valid qualification.

Specialization *

Select at least one specialization.

Languages Preferred *

Select at least one language.

Address *

Enter a valid address.

City *

Enter a valid city name.

State *

Select a valid state.

PIN Code *

Enter a valid 6-digit PIN code.

NMC Registration No. *

Enter a valid NMC registration number.

NMC validation date *

Please select NMC validation date.

Upload Passport size photo *

Upload a valid passport size photo.

Upload Educational qualification *

Upload a valid educational qualification document.

Upload ID Proof *

Upload a valid ID proof document.

IFSC *

Enter a valid IFSC (e.g., ABCE0XXXXXX).

Branch *

Bank Name *

Account Name *

Account Number *

Account number must be 9–18 digits.

Re-enter Account Number (paste disabled)

Account numbers do not match.

Registration Successful

Doctor Name: —

You have been successfully registered in Remedia Telemedicine Platform powered by Margy Tech Private Limited.

We have sent the Login credentials to your registered Email.

Thank you for joining us.

Step 1: Email authentication

Step 2: Personal Info

Step 3: Bank Details

Registration Successful