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Patient Portal Id Registration

Enter identification number (without -)
Enter handphone number (without -)
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I agree with the terms and conditions stated in the Terms & Conditions. I hereby declare that the information given during registration will be used for the Online Services in the future. I understand that giving false information or giving other people access my ID, or misuse of the Online Services application, is against the law and will be charged. (Please read through the Terms and Conditions before you click on the Submit button.