MediLink Global - Patient Registration

👤 Personal Information 基本信息

Please fill in your personal details as they appear on your passport

First Name 名 *

Last Name 姓 *

Nationality 国籍 *

Age 年龄 *

Gender 性别 *

Phone 手机号 *

Email 邮箱 *

Help us understand your medical needs

Chief Complaint / Main Symptoms 主诉/主要症状 *

Preferred City 期望就医城市 *

Preferred Time 期望时间

Insurance 是否有保险（选填）

Upload your recent medical reports, CT scans, MRI, blood tests, etc.

📤

Click to upload or drag files here

Supports: PDF, JPG, PNG (max 20MB per file, up to 10 files)

📄

Liver_MRI_2026_03.pdf

4.2 MB · Uploaded

MRI Report ✕

🖼️

Blood_Test_Results.jpg

1.8 MB · Uploaded

Blood Test ✕

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Referral_Letter_Singapore.pdf

2.1 MB · Uploaded

Referral ✕

← Back to Chat

🎉

Your medical service ticket has been created. An advisor will contact you shortly.

Your Ticket Number 工单编号

MLG-2026-0827-0042

📋 Next Steps 后续流程：