At home lab work_payment2 - expathealthservices

"*" indicates required fields

Price of labs plus house call fee depending on location

Name*

First Last

Passport/Cedula Number*

Date Of birth*

Email*

Gender*

Male

Female

Phone*

WhatsApp number*

Address in Panamá*

Street or Hotel Name City

Street or Hotel Name

Date*

Select Time*

File

Accepted file types: jpg, png, pdf, mp4, Max. file size: 512 MB.

If no lab order, list exams in text box

Card number*

Expiration date*

Security code*

Typer Of Card*

VISA

MASTERCARD

Your transaction is secure with our encrypted form