Application Form for Registration in JK Medical Council.

Instructions to fill the Form

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Type of Registration *:
 Qualification Status *:
Have You Passed your
Qualification from J & K*:
APPLICANT DETAILS
Name of the Applicant(Please don't add the prefix "Dr" alongwith your name.)*:
 Gender:  Male Female
Father's Name*
 Mother's Name
 Nationality*

Date of Birth*

Mobile No.*

Alternate Mobile No.
Telephone No Email*: Aadhar Card / Passport No*:
Permanent Address (Except State, District and Pincode)*

State/UT

District

Pin Code

My Correspondence Address is same as Permanent Address
Correspondence Address (Except State, District and Pincode)

District

Pin Code
MBBS Registration Details of J and K Medical Council
Are You Registered with any State Medical Council Under Indian Medical Council Act 1956 ? *
Are You in Government Service*

 Appointment*
Institution to which Attached *
Have you ever been Convicted/imprisoned*

 If Yes Give Details
Whether engaged in teaching/ research / practice of Medicine ?*


Category* :
SC    ST    OBC    RBA    General    Others   


Religion*:
Hinduism    Muslim    Sikhism    Christianity    Jainism    Buddhism    Others