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New Hospital Profile Creation
Category:
Practice Permit Renewal
*
Fill the Form below. All fields are required. Please Sign In instead if you already have a portal account.
Hospital Name
RC Number
Mobile Telephone Number
Email Address
*
State of Location
*
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Abia
Adamawa
Akwa Ibom
Anambra
Bauchi
Bayelsa
Benue
Borno
Cross River
Delta
Ebonyi
Enugu
Edo
Ekiti
FCT
Gombe
Imo
Jigawa
Kaduna
Kano
Kebbi
Kogi
Kwara
Lagos
Nasarawa
Niger
Ogun
Ondo
Osun
Oyo
Plateau
Rivers
Sokoto
Taraba
Yobe
Zamfara
City of Location
*
Contact Address
Password
*
Your password can’t be too similar to your other personal information.
Your password must contain at least 8 characters.
Your password can’t be a commonly used password.
Your password can’t be entirely numeric.
Password confirmation
*
Enter the same password as before, for verification.
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