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Patient Name Email Address Phone Number Date of Requested Appointment Doctor Requested No preference Dr. Chakra Raj Pandey Dr. Rajiv Baral Dr. Ram Thapa Dr. Ashok Paudel Dr. Amit Thapa Dr. Jayan Man Shrestha Dr. Anand Ghimire Dr. Jenu Suwal Pradhananga Dr. Jit Prakash Shrestha Dr. Jasma Mally Dr. Prajjwal Malla Dr. Subash Kharel Dr. Nidhi Thapa Dr. Prabhat Adhikari Dr. Grishma Shrestha Dr. Namita Adhikari Dr. Prashamsha Tamrakar Reason for Visit Submit Request