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Registration Form




Choose your week of prenancy to get the relavent package
 
Maternity Package - the Pregnancy is less than 18 weeks
Delivery Package - the Pregnancy of over 18 weeks

Maternity package:
** For Online Payment Only

Your own question

Please provide us your information for your purchase
Full name:
 *
Date of birth:
 *
Due date
 *
Telephone/ Fax:
 *
Email:
 *
HRN (if any):
Address:
 *


Bank Account Information

Bank account: HANOI FRENCH HOSPITAL COMPANY LIMITED

Bank Account No. (USD): 2003155-001

Bank Account No. (VNĐ): 2003155-003

Bank Address: INDOVINA BANK - HA NOI BRANCH
88 Hai Ba Trung, Hoan Kiem, Ha Noi.

* Get 5% off for online registration and bank transfer payment.