Update Company | Alyssa

Basic Info

Company Tax ID *

PatRangsit

Company Name *

Company ID *

Company Type *

Note

Contact Info

Email *

Social Media ID (Line ID)

Website

Mailing Address

Address Line 1 *

Address Line 2

Address Line 3

City

State

Country

Postal Code

Phone Number

HIS Installation

System ID

System Name (HL7 Application Name)

System Version

Description

Site Name (HL7 Facility)

Select Faclility

Hospital

Other

Other Facility Name

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24-08-2019, 10:10 AM