Volunteer Support for COVID-19
Join the Medical Emergency Against COVID-19. Register as Volunteer, if Government of India will ask for help from Dental Surgeons.
For more information please contact : Dr. Robin Malik - 9212302866, Dr. Chandresh Shukla - 9977511111, Dr. Jatin Aneja - 8882351115, Dr. Akhilesh Tripathi - 9536032117
Email address *
Name *
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Qualifications *
Required
BDS Passing Year *
Occupation *
Address *
City & State *
Your Present Location
Mobile No *
DCI Registration No. *
Valid ID Proof No. *
Please mention type of ID Proof as well - Aadhar Card No., Drving Licence No, Voter ID Card No., Passport No. (Example : Aadhar Card - 111111111111)
Declaration *
Dental Doctor's / Surgeon's, who want to volunteer for COVID-19
Required
A copy of your responses will be emailed to the address you provided.
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