Registration Form
PSCO Membership Form
Name
*
Designation
Professor
Associate Professor
Assisant Professor
PMO
SMO
MO
Resident
Other
Speciality
Clinical Oncology (Radiation Oncology)
Medical Oncology
Hematology
Pediatric Oncology
Nuclear Medicine
Radiologist
Medical Physicist
Medical Technologists
Others
Qualification
Address (Residence)
Adress (Hospital)
Phone (Residence)
Phone (Hospital)
Adress (Clinic)
Phone
*
Phone (Clinic)
Email
*
Reference
Please Upload Following Documents
Recent Photograph
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Complete Updated Resume
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Primary Qualification (Degree)
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Current Appointment Letter
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Two Respective Field References
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