Submit Your Medical Reports

Send your diagnosis, scans, and treatment history for free. I’ll review them and guide you on the next steps — no payment required at this stage.

Patient Information Form

Please fill out the form below. I’ll get back to you within 24 hours.

Thank you!

Your information has been submitted successfully. I’ll review your reports and contact you soon.

Full Name *

Email Address *

Phone Number *

Country *

Medical Condition / Diagnosis *

Treatment History (if any)

Upload Medical Reports (Scans, Lab Results, etc.) *

Upload Scan 1 (PDF, JPG, PNG) No file chosen

Upload Scan 2 (Optional) No file chosen

Upload Scan 3 (Optional) No file chosen

Maximum file size: 10MB per file. Supported formats: PDF, JPG, PNG.

Additional Information or Questions

I consent to Mahtab.in contacting me via WhatsApp or email regarding my medical inquiry. I understand that my information will be handled confidentially.

Note: This service is completely free. No payment is required to submit your reports.

What Happens Next?

Here’s what you can expect after submitting your form:

1. Review

I’ll personally review your medical reports and condition within 24 hours.

2. Consultation

I’ll contact you via WhatsApp/email for a free 15-minute consultation to discuss your options.

3. Plan

You’ll receive a detailed treatment plan, hospital recommendations, and cost estimates — no obligation.