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Cancel Appointment
About Making an Appointment
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You can cancel an appointment by filling up this form.
Patient information
Patient's name *
(as in NRIC/Passport)
Patient's NRIC / Passport No / FIN *
Date of birth *
Gender *
Please select...
Male
Female
Appointment information
Current appointment date
Contact information
Name *
Email *
Contact No. *
Fax
Verification code *
(case-sensitive)