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Membership Form

Instructions for Submission of the Application Form

This form is modified for Mumbai branch.
Please take a printout of the form and fill all the information in block letters.

Pay two cheques as follows:

1. To " Dr. G. S. Ambardekar Anaesthesia Society " Rs. 500 ( Five Hundred)

2. To "Indian Society of A'logists-Mumbai Branch". Rs. 3550
(Three thousand five hundred fifty )

Attach one stamp size photograph with the name written on the back and affix another photograph on the application form.

Send the form, photos & cheque by post to:
Attention - Dr. Manju Gandhi,
Secretary, 'ISA-Mumbai',
Department of Anaesthesia,
B Y L Nair Hospital, Bombay central,
Mumbai, 400 008

For queries regarding the application,
contact secretary ISA-Mumbai at 2301 8136 or
2308 1490 (Ext. 332, 333, 334)

Membership Form

Download Membership Form (Microsoft Word Format. Size 30.5 KB)

Pls download the ISA Membership forms (in word Document) from the above location , take a print out fill it up and mail it to above address.

Download Membership Form (Html Format)

Pls download the ISA Membership forms (in HTML Document) from the above location , take a print out fill it up and mail it to above address.

Membership

•	Instructions for submission

•	Membership Form