ILBS referral coordination
New patient referral
Patient & admission identity
Scan a patient document (optional)
Photograph a label, face sheet or report — or choose a PDF — to pre-fill the fields below
Take photo / choose file
Patient name
Age
Gender
Select
Male
Female
Other
UHID number
IPID number
Patient location
Ward / unit
Select ward
Aayushman Bharat
COVID General Ward
Comfort Care Ward
DayCare Nephrology
G I Bleed ICU First Floor
General Ward A Second Floor
General Ward B Second Floor
General Ward C Second Floor
General Ward D
General ward A (Ph-2)
General ward B (Ph-2)
HDU Phase-II
HPB Surgical ICU Third Floor
ICU Isolation
Liver ICU Phase II
Liver ICU Second Floor
Medical ICU Second Floor
Oncology (Ph-2)
Paediatric General Ward 2nd Floor (Ph-2)
Paediatric Isolation Ward (Ph-2)
Paediatric Medical ICU Second Floor
Paediatric Semi Pvt Ward (Ph-2)
Paediatric Ward Second Floor
Post Operative Area Third Floor
Private Room 2nd floor (Ph-2)
Private Room 4th floor (Ph-2)
Private Room 5th floor (Ph-2)
Private Room Fourth Floor
Private Room Third Floor
Private Room Third Floor (B)
Pulmonolgy Ward(Semi Pvt) SF Ph-2
Renal ICU 4th Floor Ph-1
Semi Private (AUD ) Ward
Semi Private Room 1st floor (Ph-2)
Semi Private Room 2nd floor (Ph-2)
Semi Private Room 4th floor (Ph-2)
Semi Private Room Third Floor
Super Economy Ward
TRANSPLANT ICU
Transplant HDU
VIP Suite 5th Floor (Ph-2)
VIP Suite Fourth Floor
Room / bed number
Referral details
Referring department
Select department
AUD
Anaesthesia & Critical Care
Cardiology
Clinical Nutrition
HPB Surgery
Hepatology
Internal Medicine
Interventional Radiology
Medical Oncology
Nephrology
Neurology
Nuclear Medicine
Oncology
Other
Pediatric Hepatology
Psychiatry
Pulmonary Medicine
Pulmonology
Radiation Oncology
Renal Transplant and Urology
Urology
Type of referral
Opinion (one-time)
Opinion with follow-up
Transfer request
Urgency
Urgent (2–6 hours)
Routine (within 24 hours)
Consultant to whom referred
Select consultant
Dr. Prashant
Dr Arun Sood
Dr Balram Mishra
Dr. Anoop Saraya
Dr Nihar Mohapatra
Dr Nilesh Patil
Dr Ragini
Dr. Shridhar Sasturkar
Dr. Viniyendra Pamecha
Dr Ankur Jindal
Dr Chitranshu Vashishtha
Dr Harsh Vardhan Tevethia
Dr Jaifrin Daniel
Dr Rajan V
Dr Satender Pal Singh
Dr Shasthry SM
Dr Srajit Singh
Dr Vikram Bhatia
Dr Vinod Arora
Dr. Ashok Choudhury
Dr. Manoj Kumar
Dr. Rakhi Maiwall
Dr. Shiv Sarin
Dr.Ibrar Ahmed
Dr.PhoolChand
Dr.RaviNishad
Dr Mradul Kumar Daga
Dr YASHWANT PATIDAR
Dr. Amar mukund
Dr. Deepti Sharma
Dr. Puja Sahai
Dr.Nikhil Himthani
Dr Chandani Bhagat
Dr Hari Shankar Meshram
Dr. Rajendra P Mathur
Dr Bhargavi Ramanujan
Dr Roshan Koul
Dr Vikrant S
Dr. Bikrant Bihari Lal
Dr. Rajeev Khanna
Dr. Seema Alam
Dr Mohit Varshney
Dr Arvind Tomar
Dr Debajyoti Bhattacharyya
Dr Indernath Verma
Dr. A S Jadaun
Clinical notes
Brief clinical history
Additional notes
Attachments / reports (optional, up to 5 files)
Submitted by
Your name
Your email
Contact number
Submit referral