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India Aeromedical Services Pvt Ltd, is reachable round the clock. Please note our specific telephone numbers in order to reach us in case of an emergency. You can contact us round the clock, 365 days a year on our hotline numbers: 98200 43432 & 98210 21255.

CONTACT ADDRESS

INDIA AEROMEDICAL SERVICES PVT. LTD.
Registered Office
302 , Saqib , TPS 3, Turner Road
Above Tawa Resturant
Bandra ( west )
Mumbai 400050
Contact Numbers.
022 - 6702 3861 ,022 - 2642 5335
Fax Num 022 - 6702 3862
  Fax : +91-22-26113627

Mumbai Branch Office
103, Mawah House
Saki Vihar , ahead of Picnic hotel
Andheri ( East )
Mumbai 400072
Contact Numbers
022 - 6171 2345
Fax Num 022 - 6171 2346

Kakinada Branch Office
C/O Sai Sudah Hospital,
# 21 -1-24 , Jawahar Street
Salipeta, Kakinada - 533001
Andra Pradesh
Contact Numbers
0884 - 645 5108 0884 - 236 1155
Fax Num - 0884 - 2345979

24 Hours Helpline Number
+ 91 -09320301444
+91-022-61712345

E-mail: info@iasindia.com

AIR  AMBULANCE REQUEST AND MEDICAL INFORMATION FORM

Patient Name:

Family Name/Other Name

Nationality

  Male    Female

Age

Address:

City:

  Zip:

State:

Country:

Phone:

Passpot No. :

Casualty's Doctor:

Doctor's Tel No.:
Doctor's Fax No.:
Provisional Diagnosis:
Is the disease contagious or infectious in any form: YES:       NO:
Clinical Details:(Please mention if on any monitoring equipment)
Pulse: /min
BP:
Resp.Rate:
State of Conciousness:
State of Urine Output:
E.C.G.

Other Clinical Details:

Treatment given at present:(Please mention about any blood transfusion and blood group if known)
Details of investigation if any:
Destination Hospital:
Name of the Doctor to be Contacted at the Destination Hospital: