Unisafe Health ID

Full Name *

Father's Name *

Email Address (Optional) Email is optional but recommended for account recovery

Mobile Number * 10 digit mobile number

Date of Birth *

Gender *

Aadhar Number * 12 digit Aadhar number

PAN Card Number (Optional) 10 character PAN number (e.g., ABCDE1234F)

Permanent Address *

State *

District *

Zip/Postal Code * 6 digit postal code

Local Police Station *

Photograph *

Upload Photo (Max 5MB) Supported formats: JPG, PNG, GIF. Photo will be automatically compressed.

Password *

Confirm Password *

Please pay the registration fee and provide the UPI reference number and screenshot for verification.

Tap the QR to open your UPI app. Or scan to pay (₹300). Please add your mobile number in UPI remarks.

UPI Reference/UTR Number *

Upload Payment Screenshot *

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