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Applied for Life Member
Member in Waiting
Name
Fathers Name / Husband Name
Age
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Gender
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Male
Female
DateofBirth
Native District
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Adilabad
Bhadradri-Kothagudem
Hyderabad
Jagtial
Jangaon
Jayashankar Bhoopalpally
Jogulamba-Gadwal
Kamareddy
Karimnagar
Khammam
Komaram Bheem Asifabad
Mahabubabad
Mahabubnagar
Mancherial
Medchal
Medak
Nagarkurnool
Nalgonda
Nirmal
Nizamabad
Peddapalle
Rajanna Sircilla
Ranga Reddy
Sangareddy
Siddipet
Suryapet
Vikarabad
Wanaparthy
Warangal (Rural)
Warangal (Urban)
Yadadri-Bhuvanagiri
Others
Other State
UPLOAD PHOTO
UPLOAD SIGN
Address for Communication
Present Address
Permanent Address
Mobile
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E-mail
Designation
Academic Qualificaton
For Life Member
MBBS Passed Out Year
* Input Year Like (1947)
PG DO.MS DNB Year
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MBBS University/College
PG University/College
Upload Pg Certificate
Membership Fee
For Member in waiting
MBBS Passed Out Year
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Joined PG in Opthamology Year (For Member is Waiting)
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MBBS University/College
PG University/College
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Membership Fee
Note:
For Any Technical support please call
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or Email
info@tsos.co.in
.
Payment Details:
Membership : 5000 & 18% GST : 900. Total = 5900
