UTTARANCHAL ORTHOPAEDIC ASSOCIATION

Become a member

Any member desires to withdraw his/her membership from the Association shall give a notice in writing to the Secretary not less than three month before the end of the financial year.

Membership

Contact Info

Shushrut Superspeciality Clinc,174,Haridwar Road,near SBI bank Aaraghar chowk,Dehradun

8755476767

01356672543

info@uaioa.com

BECOME A MEMBER

MEMBERSHIP FORM FOR UA CHAPTER IOA

Dear Sir,

I wish to apply for the LIFE/FULL/ASSOCIATE Membership of UA Chapter IOA

Name (Block Letter) :

Organization & Address :

Designation :

Telephone :

Permanent Address :

Telephone :

Email :

Mobile No :

Date Of Birth:

Qualification	Institution/University	Year of Passing
MBBS
MS (Ortho)/D Ortho
Publications (Attach List)
Membership No.IOA

Place :

Date :

Proposed By (Signature and Name in BLOCK Letter) :

Membership No UA IOA :

Seconded By (Signature and Name in BLOCK Letter) :

Membership No UA IOA :

Eligibility for

Life Membership	PG Degree / Diploma in Ortho	Fee 3000/-
Associate Membership	PG Student	Fee 1000/- Per Annum

Payment Details

Cheque In favour of "UTTARANCHAL CHAPTER INDIAN ORTHOPEDIC ASSOCIATION"

Online transfer to Account Number : 915010054250345

Bank Name : Axis Bank,Haridwar Road,Dehradun Branch

IFSC Code : UTIB0002675

Please Send Photocopy of MCI Registration, PG Qualification, One Photograph

MCI Registration:

PG Qualification:

One Photograph:

Scan the QR code to pay

Membership is subject to ratification in the subsequent GBM of UA IOA & Allotment of Membership number will follow the ratification

Become a member

Contact Info

Membership Form

MEMBERSHIP FORM FOR UA CHAPTER IOA

Annual Conference 2024

Annual Conference 2018