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2023-09-06T16:25:02+00:00
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Birth Date
Gender
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Female
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Nationality
Institution/ Hospital / Organisation
Position
Junior Resident
Senior Resident
Fellow
Consultant
Speciality (maximum 3)
Glaucoma
Retina & Vitreous
Cornea
Comprehensive Ophthalmology
Uvea
Cataract/Phaco
Pediatric Ophthalmology & Strabismus
Oculoplastic Surgery
Refractive Surgery
Neurophtlamology
Ocular Pathology
Microbiology
None
Present Address
City
State ( You will be part of the mentioned state chapter of YOSI)
How did you learn about YOSI?
Medical Registration Number
AIOS Membership Number ( Write N/A if you are not a member )
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Passport Size Photograph
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Upload MD/MS/DO/DNB Certificate, those in training should upload training certificate from concerned authority
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Upload MD/MS/DO/DNB Certificate, those in training should upload training certificate from concerned authority
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Upload valid government age proof
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Date of Payment
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Screenshot of Payment Confirmation
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I wish to be a YOSI Life Member,
I declare that the above details are correct. I shall abide by the regulations of the Society in force and any subsequent amendments made from time to time
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