I submit the above information is true to the best of my knowledge. I understand that Digital Doctor Clinic & Hospital (Obdu Digital Health Care Private Limited ) is relying upon all the above information as a material factor in considering my application to become a franchisee for The Digital Doctor Clinic & Hospital. I agree to supply additional information and statements from my professional associates, as and when required.

The information provided should be adequate and complete in all respects, to facilitate the selection process. (You may use additional sheets, if required).