Enrolment Form Type of Establishment : (please tick whichever is applicable): Super SpecialityMulti SpecialitySingle SpecialityDay Care CentreNursing HomeClinic Bank Details Account Name: AHPI TamilnaduAccount no: 50200039785901Bank Name: HDFC BankBranch Name: North Veli Street, MaduraiIFSC Code: HDFC0000123MICR: 625240002 Branch Code: 123