Please enable JavaScript in your browser to complete this form.Patient Name *IC or Passport Number *Contact Number *Please select the Doctor that you preferred *Datuk Dr. Liong Men LongDr. Christopher Lee TDr. Ng Kwee TekDr. Tai Lee SiangDr. Tan Boon SiangDr. Irfhan Ali B. Hyder AliDr. Tan Boon CheongPreferred Appointment Month Month: 1 Slide the value to the Month you wantPreferred Appointment Date Date: 1 Slide the value to the Date you wantQuestions for us?Submit Georgetown Specialist Hospital Sdn Bhd 12A, Jalan Masjid Negeri, Jelutong 11600, Pulau Pinang , Malaysia. Tel : +604 8275 118 Whatsapp : (+60) 11 1052 2116 Fax : +604 8286 118 E-mail :enquiries@georgetownspecialist.com Website : www.georgetownspecialist.com Copyright © Georgetown Specialist Hospital Sdn Bhd K.K.L.I.U: 1068/2022