Healthnomics Registration First Name * Last Name * Other Name Date of Birth * Phone * Email * Dependent Type ID * -- Select -- Principal Spouse Child Password * Confirm Password * Gender * Male Female Address * State of Residence * -- Select State -- Abia Adamawa Akwa Ibom Anambra Bauchi Bayelsa Benue Bornu Cross River Delta Ebonyi Edo Ekiti Enugu Gombe Imo Jigawa Kaduna Kano Katsina Kebbi Kogi Kwara Lagos Nasarawa Niger Ogun Ondo Osun Oyo Plateau Rivers Sokoto Taraba Yobe Zamfara Federal Capital Territory Healthcare Plan * -- Select Plan -- Nomics Gold Normics Bronze Normics Bronze Family Nomics Silver Nomics Silver Family Nomics Gold Family Nomics Diamond Nomics Diamond Family Nomics Platinum Nomics Platinum Family Healthcare Provider * -- Select Hospital -- Who is the Principal? * Me Other Principal ID (required if Principal is “Other”) Upload Passport Photograph * Submit Registration
