Click here to view plans

Sign up Form

Your Name*

Your Email ID*

Plan Interested In *
Basic: Rs 22500. Includes - 10 Pages, Basic Information, 1 Video / 1 Image Gallery , Select from 3 TemplatesAdvance: Rs 45000. Includes - Upto 25 Pages, Basic Information + Images/Video Gallery, Select from 5 TemplatesExpert: Rs 67500. Includes - Upto 60 pages, Basic Information+ Mulitple Images/ Video Galleries, Custom Templates

Favorite colors or colors associated with the Clinic

Enter the name of the color

URL of choice (3 in order of preference)


Template of choice

Kindly enter the template code

Any other instruction/suggestion for the template

Name of the Doctors and their brief

Enter doctor name and details

Specialization/s practiced at the Clinic

Enter doctors Specialization/s

Name of the Practice or Clinic

Enter Clinic Name

Clinic Timings/Doctor Timings and their availability

Enter timing of the clinic/Doctor

Clinic Address & Contact Details

Enter Clinic Address & Contact Details (Address, Phone no., Email Id, Mobile No.)

Services offered at the clinic

Small Paragraph/Description of the service would be nice

Equipment and Facilities at the clinic

Enter equipment and facilities available at the clinic

Social Networking links and Blog Link

Enter social Networking/Blog links like facebook, Twitter, Linkedin etc.

Payment Mode *
Cheque or Draft in the name of: “Plus91 Technologies Private Limited” and Courier to "Plus91 technologies, 501 A, East Court Phoenix Market City, Op. Giga Space, Viman nagar, Pune 411014.Neft or RTGS transfer: Account Name: Plus91 Technologies Pvt Ltd, Bank Code - ICIC000005, A.c no – 000505016504.Deposit Cash in any ICICI Bank for Account:Plus91 Technologies Pvt Ltd, Bank Bund Garden Road Branch Pune, A.c no – 000505016504.