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Name *

Type *

Facility type *

Facility Level

Specialty

KMHFR ID

Kenya Master Health Facility Registry ID

Branch name *

Physical/Postal address

Location *

Account Manager Details

First name *

Last name *

Employee ID No. / National ID *

The unique ID assigned by the health facility. (Or national ID)

Designation *

The position you hold in the health facility.

Phone number *

Email *

Password *

Confirm Password *

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