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Membership Registration

LIFE MEMBERSHIP Membership Directory
1. Eye Surgeon residing and practicing in Moradabad - Rs. 2500
2. Eye Surgeon not from Moradabad - Rs. 2500
Surname
First Name *
Father / Husband Name
Email ID *
Address *
Phone *
Education Qualification
Graduation
Post Graduation
MCI Registration No. *
State in which Registered
Introduced By
Introducer's MOS Membership No.
Demand Draft (DD) Date
Demand Draft (DD) Bank Name
Upload Scan copy of DD
only jpg allowed and size should be less than 100 kb
Upload Passport Size Photo
only jpg allowed and size should be less than 100 kb
I hereby certify that the information mentioned above are true and correct to the best of my knowledge and belief.*

Please send DD in favor of
Moradabad Ophthalmic society at Moradabad
to

Dr Smita Agrawal
Hony General Secretary,
Moradabad Ophthalmic Society

CRITERIA FOR MEMBERSHIP
The membership open to all Ophthalmologist and graduate in modern medicine who have keen interest in ophthalmology. The members not from Moradabad State will have all privilege except voting right.

The membership of all applicant has to be rectified by general house.

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