Account Registration Form

Please complete the following with patient's information. Fields marked with (*) are mandatory.

PERSONAL INFORMATION OF THE ACCOUNT HOLDER

You can see the Patient Identification Number (PIN) on any of your official receipts or previous results from St. Lukes's Medical Center

Account Information

i.e. +639101234567
You will receive a message to confirm your registration

Please Input exactly the Text Above. Text is Case Sensitive.