Registeration Form :

Note : Your name,Medical council reg NO,Password cant be edited in future.

Full Name with initial at end:

Eg . suresh.a
max 20 characters allowed.

Tamilnadu Medical council register no:

Will be used for login id
Only numbers less than 10 charactors allowed

Password:

6 to 10 letters allowed,Don't use any symbols

Select your gender:

Father Name :

Select your Date of Birth :

- -

Mobile number :

Mobile number visibility to others :

Email Id:

Address :



Pin Code :

PHC :

Block :

HUD :


Date of joining service

- -

Mode of entry into service :

Post in phc :

Undergraduation colege :

UG joined year


Marrital status :

Blood Group :

Qualification :