Online Request for CorpMediTech (Medical Equipments Loan)
For Professional Practitioners

Applicant's Details

Name:                Dr.

Registration No :      
     Age:     Years

 Martial Status   :   Unmarried     Married

Professional Qualifications:  

Residential Address:
City
Pin
State
 

Name & Address of Present Banker:                    Details & Nature of account number:

Phone (with STD Code):
Mobile No:
E-mail :
-
Business/employment Details
Whether employed: Yes     No
If Yes,
Address City Pin State
 
Whether Self Employed: Yes     No
If Yes,
Address City Pin State
 

Experience in the field:     Years

Gross Annual Income:   Rs.
Loan Details:

Project Cost :                 Rs.

Loan Amount Sought :   Rs.                Borrowers Contribution:  Rs.
                                                                                  (Contribution should be minimum 10% of the Project cost)

Purpose of the Loan:  1.For Furnishing the Clinic   
                                   2.To Purchase brand new Electro Magnetic Equipments.
                                   3.To Purchase AC/Generators/Fridge/PC/Furniture etc
(Specify any of these purposes followed by commas)  

Name of the Branch,
where loan is to be availed:     

Repayment Period Sought:       Months    (Maximum of 60 Months)

Details of Securities:     Values of Securities:    Rs.
(Note: Loans above Rs.25 Lakhs should be secured by collateral in the form of immovable properties/financial securities to the extent of 50% of the loan amount. For full details of the scheme please visit our website at www.corpbank.com)