Membership – HEALTHRAB – Health Research Advisory Board

Regular Membership Form

Any healthcare professional may become a Regular Member by filling out the Regular Membership Application Form and agreeing to the aims and objectives of HealthRAB.

Name

Cell Number

Date of Birth

Residential Address

City

State

Postal Code

Qualification

Institute

Medical College

Position/Designation

Speciality

Department

I agree with the vision and objectives of HealthRAB and wish to become a HealthRAB Regular Member (for 2 years).

Regular Membership Form

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