Paramita Foundation

Doctor Registration

Join our medical volunteer network dedicated to unity, service, and empowerment.

Jay Bhim đź’™

Respected Sir/Madam,

Welcome to the official registration form of Paramita Foundation – A Doctors’ Unit following the ideals of Dr. B. R. Ambedkar. This form is intended to collect professional and contact details of senior doctors for the creation of the foundation’s official website and professional directory. Any information, photographs, or professional details uploaded through this form will be published on the website only after obtaining the concerned doctor’s consent.

Please enter your name.
Please enter a valid 10-digit mobile number.
Please enter a valid email address.
Date of birth is required.
Please select your gender.
Native place is required.
City is required.
Please specify your city.
Please select a specialty.
Please specify your specialty.

(Please Provide Institution Name With Your Designation)

Hospital or designation is required.

Upload 1 supported file: image. Max 100 MB.

Consent Declaration *

I hereby provide my consent to Paramita Foundation for collecting and maintaining my professional details, photograph, and related information submitted through this form for official organizational purposes and website creation. I understand that any information intended for public display on the foundation website or professional directory will be published only with my permission and consent.

You must provide your consent preference.

Congratulations!

Your registration has been submitted successfully. Our team will review and approve your profile soon.

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