Vendor Registration — JupiterHealth.in

Section 1 of 5

Company details

Basic information about your organization for your vendor profile.

Legal & business info

Legal company name *

Business type *

Year established *

Registration number *

Number of staff *

Physical address

Address line 1 *

Address line 2 (optional)

City *

State *

PIN code *

Please fill in all required fields.

Step 1 of 5

Section 2 of 5

Contact information

Details of the key people we can reach for coordination and scheduling.

Primary contact

Full name *

Designation *

Email address *

This will be your login email

Mobile number *

+91

WhatsApp number (if different)

+91

Secondary contact (optional)

Full name

Designation

Email

Phone

+91

Please fill in all required fields.

Step 2 of 5

Section 3 of 5

Tax & compliance

Required for billing and regulatory compliance. Stored securely.

Tax identification

PAN number *

GSTIN *

TAN number (if applicable)

GST state *

Bank account details

Account holder name *

Account number *

IFSC code *

Bank name *

Document uploads

PAN card copy *

Upload PDF or image
Max 5MB

GST certificate *

Upload PDF or image
Max 5MB

Cancelled cheque *

Upload PDF or image · Max 5MB

Please fill in all required fields.

Step 3 of 5

Section 4 of 5

Services offered

Tell us what health services you deliver and your operational capacity.

Health services — select all that apply

Eye checkup & vision

Dental checkup

Basic health check

Blood sugar & diabetes

Dietician consultation

Mental wellness

Lab tests & blood work

Physiotherapy

ECG & cardiac

Audiometry

Skin & dermatology

Women's health

Other services (optional)

Camp capacity & operations

Camps per day (max) *

Max employees per camp *

Service description *

Minimum 50 characters. This appears on your vendor profile.

Operational geography

Bengaluru

Mumbai

Delhi NCR

Hyderabad

Chennai

Pune

Kolkata

Ahmedabad

Jaipur

Kochi

Mysuru

Pan India

Other cities (optional)

Please fill in all required fields and select at least one service.

Step 4 of 5

Section 5 of 5

Review & submit

Please review your details before submitting. Our team will verify within 2–3 business days.

Company details

Contact information

Tax & compliance

Services offered

By submitting, you confirm all information is accurate and authorize JupiterHealth to verify your details. You agree to our Vendor Terms, Privacy Policy, and Code of Conduct.

All information provided is true and accurate to the best of my knowledge.

I agree to JupiterHealth's Vendor Terms of Service and Privacy Policy.

Please accept both declarations before submitting.

Step 5 of 5

Registration submitted!

Thank you for registering as a vendor on JupiterHealth. Our team will review your application within 2–3 business days.

1

Application review (1–2 days)

2

Document verification

3

Portal access & first leads

Vendor onboarding

Company details

Contact information

Tax & compliance

Services offered

Review & submit

Registration submitted!