ISPR – International Society of Paediatric Radiology

Select Membership *

Life Membership

Amount : ₹3,000.00
GST : 18.00%
Total : ₹3,540.00

Student Membership

Amount : ₹1,500.00
GST : 18.00%
Total : ₹1,770.00

Basic Detail *

Salutation *

First Name *

Middle Name

Last Name

Email *

Phone Number *

Alternate Phone

Gender *

Date of Birth *

Address *

Country *

State *

City *

Zip Code *

Qualification Details *

Degree	Year	College/School	University	Action

Professional Details *

Current Designation *

Medical Council No. *

Affiliated Hospital Name *

Speciality (comma separated)

Hospital Address

Hospital City

Hospital State

Hospital Zip

Recommended By *

Recommendation should be done by Life members of ISPR only.

Recommender 1

ISPR No. *

Name

Phone

Recommender 2

ISPR No. *

Name

Phone

Document Uploads *

Please upload the required certificates in PDF, JPG, or PNG format (Max 5MB).

Declaration Form *

MD/DNB Certificate *

Medical Registration Certificate *

Training/Experience Certificate

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ISPR Membership Registration