Kharghar Doctors' Association

Personal Information

Enter your basic professional details

Full Name *

Mobile Number *

Email Address *

City *

Specialty *

Medical Registration Number *

Select your preferred membership type

Annual Renewed every year

Lifetime One-time membership

Upload required supporting documents

Medical Registration Certificate (PDF/Image) *

Click to upload or drag & drop PDF, JPG, PNG — Max 5MB

Passport Size Photo (Optional)

Click to upload photo JPG, PNG — Max 2MB

Confirm your eligibility

I confirm that I am a registered medical practitioner.