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Middle Name

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Note: Continue by filling up below remaining details and complete registration by clicking on the "Register" option at the bottom.

Type of membership

Life Membership

Associate Member

Qualification

MS Orthopedics

Diploma Orthopedics

DNB Orthopedics

Others

Upload Postgraduate Qualification (MS/DNB/Diploma etc) certificate.
For associate membership, postgraduate trainees need to upload certificate from head of department stating that they are currently enrolled in a training course

Upload MCI registration certification

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Address *

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I certify that the information submitted in this application is true and correct to the best of my knowledge.

I further understand that any false statements may result in denial or revocation of the certificate.

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Bank Account Detail

Name: NORTH ZONE ORTHOPAEDICS ASSOCIATION, CHANDIGARH
AC No.: 51201131000486
IFSC: PUNB0325200

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