Coming Soon This Site is Coming Soon 00 Days : 00 Hours : 00 Minutes : 00 Seconds Sign up to receive updates Get both our special offers and our oral health maintenance tips directly to your inbox! Full Name : Email Address : Gender MaleFemale IC/Passport No.: Nationality : Home Address : Date of Birth: MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Date12345678910111213141516171819202122232425262728293031 Year1920192119221923192419251926192719281929193019311932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025 Marital Status: MarriedSingleDivorced Appointment Date: Appointment Time (Malaysian Time): 08000815083008450900091509300945100010151030104511001115113011451200121512301245130013151330134514001415143014451500 Contact No.: Order Number : Appointment slots are only confirmed after acknowledgement email from LifeCare. By providing my personal information in this form, I agree that the information is correct. I consent to the processing of my personal data by Life Care Diagnostic Medical Centre Sdn. Bhd.,in accordance to privacy policy.