Registration
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Registration
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Do you want to be a Member of Indian Psychiatric Society West Bengal State Branch? Then please fill up the form:
Please tick applicable
Dr.
Mr.
Mrs.
Ms.
Your First Name
Your Middle Name
Your Last Name
Your Email
Password
Qualification
DPM
MD
DNB
DPM+MD
DPM+MD+DNB
DPM+DNB
MD+DNB
MD+DNB+PHD
MSC
MSC+PHD
MRCPsych
Date of Birth
Blood Group
Mobile or Whatsapp
IPS National Membership Status
Life Ordinary
Life Associate
Life Fellow
Membership No.
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Declaration : I solemnly affirm that I will uphold the aims and objectives of the Indian Psychiatric Society, West Bengal State Branch to the best of my ability and agree to abide by its Constitution and bye-laws, which may come into force from time to time.
