MAMCOS : Maulana Azad Medical College Old Student Association

Mr./Mrs.*

First Name *

Last Name *

Date Of Birth *

Permanent Address *

Mobile Number *

Email *

Year Of Joining MAMC

Join AS

Year Of Graduation

Year Of Diploma

Year Of Post Graduation

Speciality *

Country

State

City

State MC / MC ID Proof
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ID / Address Proof
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Select Self Employed/Job

Clinic/Hospital Name

Designation

Country

State

City

Pincode

Office Number

Your registration is subject to manual check. You will receive call/email for verification.

I hereby declare that above information is correct as per my knowledge and records and i share the responsibility of authentication of the same.

Registration