Name
Residential Address
Institute/Organization
Section / Department
Field of Interest
Designation
Phone Res./Cell
Off.
Email
Qualification for Full Membership:
MBBS
Other Qualification
Speciality
Qualification for Associate Membership:
BScPh.DDCH
MScDVM
M. PhilPharma.D
Life Time Membership Fee:
Full Member
Rs. 5,000/- for Consultants Rs. 3,000/- for others
Overseas Member
US $. 100/-
Associate Member
Rs. 3,000/-
On-line Account No: 0024-20001912322 Infectious Diseases Society of Pakistan. Soneri Bank. Aga Khan University Branch, Karachi.
Note: Please attach the Bank deposit slip with the filled form.
Attach Your File Only Jpg, PDF
Date:
