ISA Web Register Form

ISA Private Practitioner Forum (PPF)

Programme Head: Dr. Virendra Sharma

Coordinator: Dr. Pankaj Gupta

a) ISA Public Awarness Flier
b) PPF Guidelines

1

BASIC INFO

ISA No. *

Name *

DR.

Age *

Gender * MaleFemale

Mobile No *

Email Id *

State *

City *

Name of Hospital/Private Practitioner *

Areas of Interest *

2

REMARKS

Remarks

Register Clear
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Sno.	ISA No	Name	Age	Gender	Hospital Name	Remark	City/State
1	K1686	Kalyan Kadam	48	Male	Govt dist hosp		PARBHANI / MAHARASHTRA
2	A3458	Dr. Sulbha dayaram Salunkhe	40yr	Female	Anaesthesia		JALGAON / MAHARASHTRA
3	A2208	A.Naga Venkata Supriya	33	Female	Freelancer		HYDERABAD / TELANGANA
4				Male			--SELECT-- / --SELECT--
5	p1258	pramod	51	Male	HCG Panda Cancer hospital		KHORDHA / ODISHA
6	R0228	B S R N MURTHY	71	Male	Private practitioner	Nil	KHAMMAM / TELANGANA
7	R0228	B S R N MURTHY	71	Male	Private practitioner		KHAMMAM / TELANGANA
8	J0886	NIRMALA JEYARAMAN	42	Female	PARVATHY NURSING HOME		TIRUNELVELI / TAMIL NADU
9	89	Shrey kakodkar	27	Male	Goa medical college	Anaesthesia rates	SOUTH GOA / GOA
10	V1830	Vamsi nath CHILLARA	37	Male	Soumya hospital		HYDERABAD / TELANGANA
11	A4147	Alpesh Bhanushali	32	Male	Private		MUMBAI SUBURBAN / MAHARASHTRA
12	D1477	Rituparna borah	37	Male	East point		SIVASAGAR / ASSAM
13	A1546	dr ashok ranjan	38	Male	Private practitioner		RANCHI / JHARKHAND
14	M1662	Dr.P.MOHAN	63	Male	freelance		KANYAKUMARI / TAMIL NADU
15	12121212	rajat	23	Male			--SELECT-- / --SELECT--
16	S5248/A	Sakthi Vignesh G	32	Male	Apollospectra		CHENNAI / TAMIL NADU
17	S5704	Sathya Narayanan	29	Male	Free lancer		CHENNAI / TAMIL NADU
18	R -860	Ramlal VERMA	52	Male	SHRC		DEWAS / MADHYA PRADESH
19	isa121	sonali	27	Female	Pt. B.D sharma collage	Demo	ROHTAK / HARYANA