Govt. of NCT DELHI

Dilli Homeopathic Anusandhan Parishad
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Nehru Homoeopathic Medical College and Hospital Alumni Association
Alumni Registration Form

Membership Fee: Rs. 500 for one time registration.

Note : A person shall be entitled to participate in the activities of
the alumni association only if he has made his payment of
the membership fee.

     

Name

  
Date of Birth  
Date Month Year
Address for correspondence  
State  
Country  
Pin  
Telephone  
Mobile No.  
E-mail  

Year of Passing – (Batch)

  

Distinction/Prizes

  

   

Your interest of participation in

Organizational effort

  

Database development

  

Seminars/Workshop/training programs

  

Academic activities

  

Socio-cultural programs

  

Counseling

  

   

Particulars of payment of fee

Cheque No:

Bank:

 
         
Date (DD-MM-YYYY) :
Amount:
  
     
 




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