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NMOCON 2026 – Registration Form
Category
*
UG Student Till Internship
PG Resident
Doctor
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NMO Membership Number / NMO Application Number
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Full Name
*
Gender
*
Male
Female
Other
Age
*
Date of Birth
*
PAN Card Number
Mobile Number
*
Email
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Blood Group
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Select Blood Group
A+
A-
B+
B-
O+
O-
AB+
AB-
Address Details
Zone
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North Zone
West Zone
Uttar Pashchim Zone
Western UP
Eastern UP
North East
East Zone
Central Zone
South Central Zone
Assam Zone
South Zone
Prant
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Prant Secretary Name
Secretary number
Permanent Address
Permanent State
Permanent City
Same as Permanent Address
Current Address
Current State
Current City
Qualification
MBBS
Dental
Doctor Specialties
Medical Specialty
Select
Anatomy
Physiology
Biochemistry
Pathology
Microbiology
Pharmacology
Forensic Medicine and Toxicology
Community Medicine
Oto-rhinolaryngology
Ophthalmology
General Medicine
Pediatrics
Dermatology, Venereology & Leprosy
Psychiatry
General Surgery
Obstetrics and Gynaecology
Orthopedics
Anesthesiology
Radiodiagnosis
Emergency Medicine
Pulmonary Medicine
Immunohaemotology & Drug Transfusion
Dental Specialty
Select Dental Specialty
Oral Medicine & Radiology
Oral & Maxillofacial Surgery
Oral Pathology
Pediatric and Preventive Dentistry
Public Health Dentistry
Orthodontics
Prosthodontics
Periodontics
Conservative & Endodontics
Super Specialty
Doctor Registration Number
*
Academic
Under Graduate College Name
City
State
Year of Admission
PG College Name
PG City
Post Graduation Year of Admission
Professional
Private Practice
College Faculty
Retired Doctor
Hospital Name
Address
City
State
Medical College Name
Current Designation
City
State
Last Working Hospital Name
Last Designation
City
State
Spouse Details
Coming with Spouse?
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Spouse Name
*
Spouse Mobile
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Will someone accompany you?
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