Membership

Regular Membership Form

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

Name

Cell Number

Date of Birth

Residential Address

City

State

Postal Code

Qualfication

Institute

Medical College

Position/Desigation

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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