Plan your consultation.

A simple, guided appointment request for pulmonary and respiratory concerns. It takes about 2–3 minutes.

Professor & HOD PGIMER & Capital Hospital Founder, eNiswas Bhubaneswar

01 · ABOUT YOU

Let’s start with the patient.

Only the essentials first. We’ll ask about the respiratory concern next.

Patient name *

Age *

Gender *

Mobile *

Email (optional)

City

02 · YOUR CONCERN

What brings you in?

Choose the closest match. You can add details in your own words.

Main concern *

Duration

Current severity

Tell us briefly

Known respiratory condition

Need urgent care?
If there is severe or rapidly worsening breathlessness, blue/grey lips, severe chest pain, fainting/confusion, or significant coughing of blood, seek emergency medical care rather than waiting for an appointment.

03 · MEDICAL CONTEXT

Help the doctor prepare.

These fields are optional, but useful for a respiratory consultation.

Current medicines / inhalers

Previous tests or reports

Anything else the doctor should know?

If you already have reports, please keep them ready for the consultation. The appointment request does not itself constitute a diagnosis or treatment recommendation.

04 · FIND A TIME

Choose your preferred slot.

This is a request. The clinic will confirm the final date and time.

Preferred date *

Preferred time *

9–10 AM

10–11 AM

11 AM–12 PM

2–3 PM

3–4 PM

4–5 PM

Any available slot

Consultation mode *

In-person
At clinic

Online / video
Remote consultation

I confirm that the information provided is accurate to the best of my knowledge and agree to be contacted about this appointment request.

✓

Request received.

Your appointment request has been sent to the clinic.

Reference:

Please keep this reference available when the clinic contacts you.

Appointment request · Dr. Thitta Mohanty · Pulmonary Medicine · Bhubaneswar