Pediatric Infectious Diseases Academy |

To become member it will cost ₹ 2000 to fill out the membership application form for IPTA's chapter. If you agree, then please proceed.

First Name *

Middle Name

Last Name *

Central IAP membership *

Upload Photograph *

Address *

State *

City *

Postal Pin Code *

Country *

Alternate Mobile Number

Date of Birth *

Gender *

Degree Name *

University Name *

Qualification Year *

State

Registration Year

Registration Number

Upload Certificate

We Don't accpect the proposer and seconder start with AL ID

Proposer IAP Membership Number *

Seconder IAP Membership Number *