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Online Registration

Note: Please spell your name the way you would want it to appear on your Certificate.
First Name* *** It will be assigned as user name
Middle Name* Last Name*
Gender* Male Female
Date of Birth* Country*
Select Profession Type* Medical Prof. Academician Student Researcher
Paramedical Prof. Others
Name of Organisation(Present):(50 chars)*
Designation in Organization:
Location* State UT
City/Town Village
Pin Code:*
Contact Details
Landline Mobile
Login Details
Note:Enter your email-id correctly. E-mails would be sent to this e-mail ID.
E-mail ID:* Alternate e-mail ID:
A) How did you come to know of this Course
B) Where / How would you access this Online Certificate Course:
Enter the Verification Code as displayed in the image