IJR Registration Form
This form registers data of new surgeons for IJR.
Name *
Your answer
Associated Hospitals / Institutions / Clinics *
Note: Please enter city in brackets with above names. You can enter multiple entities separated by commas. e.g hospital1(city1), hospital2(city2), etc.
Your answer
Speciality *
Your answer
Email Address *
Your answer
Contact Number *
Your answer
Member of ISHKS? *
MCR(Medical Council Registration) Number
Your answer
Submit
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