TracVirus

Clinic Registration

COVID-19 TEST - Recruitment of panel Clinic

Be the forefront in healthcare and act now. Limited time, doctors and consultants enroll today for FREE!

Affordable COVID-19 testing for your patients
COVID-19 testing result e-Cert verification endorsement by law enfocer
Provide PCR test swabber to take sample for you*

Clinic Details

1. CLINIC NAME

2. REG NO.

3. CLINIC ADDRESS

4. POSTCODE

4. CITY

5. STATE

6. PERSON IN CHARGE

7. MOBILE NO.

8. NRIC/PASSPORT NO.

9. EMAIL

10. SWAB LICENSE
Outsource Swabber Licensed to Swab

11. FORM UPLOAD

a) Please download the form. Fill up all the details, signatory and company stamp. Upload to ud for approval.

b) Upload your medical license and/or qualification or verification in 1 file.

* Allowed document format is .JPG, .PNG & .PDF only

12. PAYEE NAME

13. PAYMENT ACCOUNT NO.

14. PAYMENT BANK

By signing the registration form, I am giving my consent to the processing of personal data to provide me with information about services that the Organization believes to be of potential interest to me; have surveys and marketing, statistical and other research carried out; inform me of new services of the Organization.

REF ID

TRI-G TECHNOLOGIES SDN BHD (a Nexgram Group Company)
6-2, Tingkat 2, Jalan PJS 8/12A, Dataran Mentari,
46160 Petaling Jaya, Selangor, Malaysia.