22nd Uttara-Eyecon 2026 | Become a Member

Membership

Fee 2000 INR

Offer Short period

Approval Manual admin review

Short-period membership opportunity at a special discounted fee
Ideal time to join an emerging state society and stay connected long term
Useful for doctors who want updates on future meetings, announcements, and academic activities
Membership fee currently set at 2000 INR

Membership Form

Fill your details and save the application

The applicant fills this form directly, then pays the membership fee online through Razorpay. The admin will review the paid request and approve it manually.

Personal Information

Title *

Full Name *

Father's Name

Date of Birth

Gender *

Mobile Number *

Email *

Postal Address *

City *

PIN Code

State *

Country *

Educational Qualification

MBBS College

MBBS Passing Year

PG Degree

PG College

PG Passing Year

MCI / State Council Registration No.

Membership Details

Institute / Hospital *

Designation *

Membership Type *

Category *

Document Uploads

Upload the required documents for admin verification. These will be reviewed before membership is approved.

Passport Size Photograph * (JPG / PNG — max 150 KB)

PG Degree Certificate * (PDF / JPG / PNG — max 5 MB)

MCI / State Council Registration Document * (PDF / JPG / PNG — max 5 MB)

I hereby certify that the information mentioned above is true and correct to the best of my knowledge and belief. Membership becomes active only after admin approval.

Payment and Approval

Awaiting details

Membership Type Life Membership

Membership Fee Rs. 2,000.00

Platform Fee Rs. 80.00

Total Payable Rs. 2,080.00

Payment Gateway Razorpay

Admin Action Review and approve after payment

Receipts

Membership payment history

Payment receipt confirms the transaction. Final membership approval still depends on admin review.

No membership receipt yet. Save the application details and complete the Razorpay payment to generate the first receipt.