Buy Dialysis Frequent Plan Registration Form

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DIALYSIS FREQUENT PLAN

Name *

Mobile *

Date Of Birth *

Gender *

Male Female

Email *

Pincode *

Address1 *

Address2

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Select Plan Validity

Click to Upgrade Plan

Monthly

Rs. 1400

when purchased
for 6 months

Yearly

Approx. 35% Off

Rs. 16800

Rs. 11000

Special Price (Rs.): Approx. 35% Off
1400/month x 12 months = ~~16800~~
1400/month x 12 months = 11000

IGST @18% (Rs.):

Grand Total (Rs.):

Click to Apply Coupon

Coupon Code

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Consultant Code

Please Fill Your Details

DIALYSIS FREQUENT PLAN

Select Plan Validity

Click to Upgrade Plan

Rs. 1400

when purchased
for 6 months

Approx. 35% Off

Rs. 16800

Rs. 11000

Click to Add Extra Features

Click to Apply Coupon

Yes, I have read and understood OXXY Terms & Conditions and I agree with them.

Please Fill Your Details

DIALYSIS FREQUENT PLAN

Select Plan Validity

Click to Upgrade Plan

Rs. 1400

when purchased for 6 months

Approx. 35% Off

Rs. 16800

Rs. 11000

Click to Add Extra Features

Click to Apply Coupon

Yes, I have read and understood OXXY Terms & Conditions and I agree with them.

when purchased
for 6 months