ANAH Member Registration Form
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Email *
Full Name *
Degree *
Designation *
Department/ Institution *
Office Mailing Address
Research Interest 
Name of Hospital/ Affiliation 1 *
Affiliation 2 (if any)
Type of Hospital *
Will retrospective data collection be feasible at your site? *
Required
Does your hospital use electronic medical records? *
Required
Will prospective trials be feasible? *
Required
Is biological sampling for research feasible at your site? *
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