Matsuogaoka Maternity Clinic online booking form (Minato-ku)

※ Please put the registration number shown on Doula Card

Example: From XX line, XX station, walk X min or X min by bus

※ if you live in a flat or a housing complex etc., please make sure to put the name of the building.

Example: 090-9999-9999

@
 years old

※ It may be difficult to book when a date is specified. If it is possible, please state with some flexibility such as within 1 week from X date, or between X and Y date.

※ Presence of allergy for the mother or children, hypersensitivity etc.