Indian Arthroscopy Society
Indian Arthroscopy Society
IAS

Arthroscopy

Arthroscopy
  Membership » Online Membership
  Online Membership
  Note: After submitting the form, you will get the details in the page. You should print the page and post it along with the cheque to.
  To,
Dr. Parag Sancheti
Secretary, Indian Arthroscopy Society


Dear Sir,

I wish to join the Indian Arthroscopy Society as a Life Member. I am enclosing herewith a crossed cheque/ Banker's draft/Postal Order for Rs. 1,000/- (Rs. One Thousand Only) towards subscription in favor of “Indian Arthroscopy Society” payable in Pune.
   
 
First Name:
Surname:
Address:
City:
State:
Country:
Mobile:
Telephone:

Clinic:

 Res:
Email:
Date of Birth: Year:
Educational Qualification:
Sr. No. Qualification Year and Institution
1.
2.
3.
4.
Registration:

Number:

 Place:
Hospital Affilliations:
Present Appointment:
Special Interests in Arthroscopy:

Enter Security Code :
 
 
Note: After submitting the form, you will get the details in the page. You should print the page and post it along with the cheque to.
  Dr. Parag Sancheti, 16 Shivaji Nagar,
Pune - 411 005, Maharashtra.
 
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