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CONSULT US-

Rancan Gamma Knife Centre
VIMHANS Hospital Campus
1, Institutional Area
Nehru Nagar,
New Delhi-110065
Tel : ++91-11-29849000 to 005
Fax : ++91-11-29849006
E-mail : helpline@gammaknifeindia.com

Consultation for outstation patients

i
  Yes No
Are you looking at this web site because of some neurological problem of your own or of someone you know well? 
Have you or the patient felt the need to consult or consulted any neuro specialist recently? 
Has anyone suggested "brain surgery"?
If answers to any one of above is YES, then it may be worth your while to fill up this form and mail it to us.
It will help if you can give us a copy of medical history and copies of recent scans carried out for diagnostic purposes.

Your name
 
Your address/contact
House/Street
City
State
Country
Zip/Pin
Please use the box below to describe the problems briefly (this is particularly important if medical history is not available) 
Has any neuro-specialist been consulted? Yes No

If Yes,would you like us to contact him? No
Yes 		Name of specialist
   
    Contact
   
 
  or 

Copyright © 2003, Rancan Gamma Knife Center, Vimhans
1, Institutional Area, Nehru Nagar, New Delhi-110065
Tel : 91-11-26924302/303, 26314359 Fax : 91-11-26314379 E-mail : helpline@gammaknifeindia.com

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