ClinicMaster - Health & Medical Bootstrap Template

1) Applicant Details

Full Name

Age

Male Female Other

Mobile Number

Alternate Number

Email ID

Current Address

City

State

2) Store Information

Current Store Name

Store Address & Location

Store Area (sq.ft.)

Own Rent

Monthly Rent (₹)

3) Business Details

Current Monthly Medicine Sales (Approx.):

Below ₹2 Lakhs ₹2–5 Lakhs ₹5–10 Lakhs ₹10 Lakhs+

Average Daily Footfall

Current Product Categories (tick all that apply):

Branded Medicines Generic Medicines FMCG / Wellness Surgical / Lab Home Delivery

4) Team / Staff

Number of Existing Staff

Registered Pharmacist: Yes Registered Pharmacist: No

5) Upgrade Interest (Support Required)

What support do you expect from My Sehat Point?

Branding & Interior Software & CRM Vendor & Supply Delivery & Rider App Lab & OPD Marketing & Digital Staff Training & SOPs

6) Future Goals

What is your growth target after upgrade?

Double sales (6 mo) Expand customer base Add new services Other

7) Declaration

I hereby declare that the above information is true to the best of my knowledge.

Contatc Us

Email Supports

Online Appointment

Supports

Contact Us

Newsletter

Follow Us

Start Upgrading Application

My Sehat Point – Upgrade Existing Medical Store Application Form