Sunrise Japan Hospital Phnom Penh

We Sunrise Japan Hospital are waiting for you with membership service plan to support your healthy life

Membership Course

※1 ការបញ្ចុះតម្លៃសេវាកម្មត្រូវបានអនុវត្តតែសម្រាប់ថ្លៃពិគ្រោះយោបល់ជាមួយវេជ្ជបណ្ឌិត និងការស្នាក់នៅមន្ទីរពេទ្យតែប៉ុណ្ណោះ។

※2 ថ្លៃសេវាប្រចាំឆ្នាំអាចមានការផ្លាស់ប្តូរដោយមិនបានជូនដំណឹងទុកជាមុន។

Kind of membership course※	Gold membership 【Annual Fee ＄320/Registration Fee Free until September from October Registration Fee is ＄10】 Silver membership 【Annual Fee ＄120/Registration Fee Free until September from October Registration Fee is ＄10】 Bronze membership 【Annual Fee Free until June, From July ＄10/Registration Fee Free until September from October Annual Fee and Registration Fee is ＄10】
Family name※
Given name※
Sex※	Male Female
Date of Birth	Year Month Day
Age※	Years
Address※
Phone Number ※
E-mail Address※
Nationality※	Cambodia Other
National ID※
Emergency Contact Number※
Native Language※	Khmer Japanese English Chinese Other
Second Language※	Khmer Japanese English Chinese Other
Occupation※	Student Employee Own Business Other
Name of Work Place or School※