Registration Form

Application for the Membership

(list of files you need to keep it ready before you fill up this form: click here)

Full Name *

Please enter your full name.

Address *

Please enter your address.

State *

Please enter your state.

City *

Please enter your city.

Pincode *

Please enter a valid 6-digit Indian pincode.

Mobile No *

Please enter a valid 10-digit Indian Mobile number.

Email Id *

Please enter a valid email address.

Website

Hospital Name *

Please enter your hospital name.

Degree in Orthopaedics *

Please enter your orthopaedics degree.

Year of Obtaining Degree *

Please enter the year of obtaining degree.

Medical Council Name *

Please enter the medical council name.

Membership No *

Please enter your membership number.

Percentage of annual Orthopaedics practice devoted to Total Hip and Total Knee Arthroplasty (%) *

Please enter the percentage.

Number of annual THR performed in the last year *

Please enter the THR count.

Number of annual TKR performed in the last year *

Please enter the TKR count.

Recommended By (type the name of the doctor without any prefix)

Please enter the recommender's name.

Upload Your Credentials:

Upload Your Photo *

Please upload your photo.

Only JPG / PNG file format

Upload Your Current CV *

Please upload your current CV.

Only WORD / PDF file format

Upload Your Orthopaedics Degrees *

Please upload your orthopaedics degree document.

Only JPG / PNG / PDF file format

Upload Copy of Medical Council registration *

Please upload your medical council registration.

Only JPG / PNG / PDF file format

Registration Form

Administration

PAS India

Registration Form

Registration Form

Application for the Membership

Upload Your Credentials: