Vital Reg. - KSCHMA

Welcome!

KANO STATE CONTRIBUTORY HEALTHCARE MANAGEMENT AGENCY (KSCHMA) VITAL PROGRAM SUBSCRIPTION PORTAL

Before you Proceed:

<> Make sure all the information you'll provide here are correct and accurate

<> Provide exactly your First name, Last name and e-mail address in the payment page as you provided in the registration pages

<> Confirm all Information before you proceed to the next page.

<> If you have made the registration Ealier, check here to confirm your payment Status:

Vital Registration:

Biodata:

First Name: *

Middle Name (Optional):

Last Name: *

Date of Birth: *

Gender: *

Marital Status: *

Contact Info:

National Identification Number (NIN):
Address: *
Phone Number: *
E-mail:

Blood Group: *

HCP Selection:

Choose your prepared Hospital: *

Working somewhare away from home?

Select alternative Hospital: *

Wish to be part of us?

Passport: *

Payment

You are about to proceed to the payment page:

By Clicking the next button you have agreed with the terms and conditions governing the KSCHMA Vital Program and its Payments

You can always check back to confirm your payment using the e-mail address and the phone number you provided during your enrolment: