New Doctor Registration

Fields marked * are mandatory

Doctor Details

Salutation

First Name

Website URL

Gender

Photo

Category of Placement

Type

Consulting Details

Address Line I

Address Line II

Location

District

State

Postal Code

Residence Phone

Office Phone

Mobile

Qualification

Area of Interest

Present [ Consulting / Status ]

Former Status

Additional Status

Facebook Url

Twitter Url

LinkedIn Url

Permanent Address ( only for office use )

The information you provide here will not be displayed any where in the website.

Address Line I

Address Line II

Location

District

State

Postal Code

Residence Phone

Office Phone

Mobile

State council Reg : No

Terms & Conditions

Registration charge is only Rs.3000/-

This is one time payment no updation charges and no other hidden charges.

we will give you a single page website www.medicalkerala.com/yourname and also give username and Password for updation

Duration of validity of contract will be five years from the registration date.

The above mentioned facts are true and correct in my knowledge, If not the Med-Le Services is not responsible

I agree to www.medicalkerala.com Terms & Conditions

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