This program is recognised for excellence in providing education to primary care physicians in the management of diabetes mellitus by South Asian Federation of Endocrine Societies (SAFES)

***************INSTRUCTION FOR FILLING PARTICIPANT ENROLMENT FORM************




Online Application

All red (*) marked fields are mandatory !

 
1. Personal Information details(Name, Mobile, Email, DoB, DoB proof) are compulsory.
2. MCI Registration details (MCI Reg No, Reg Certificate, Reg Date) and Qualification details (MBBS,Dept,Year,Proof) are compulsory.
3. Payment details (Mode of Payment, NEFT Refer. No/DD No, Date, Bank Name, Branch Name ) are compulsory otherwise your application will be treated as incomplete.

BANK DETAILS FOR ONLINE PAYMENT is given below:
PUBLIC HEALTH FOUNDATION OF INDIA
Account Branch :HDFC BANK LIMITED
Address :H-7, GREEN PARK EXTENSION, NEW DELHI
Account No : 50100254381662
RTGS/NEFT IFSC : HDFC0000586
PAN No. : AABAP4445L

Click here to apply online

Offline Application

For enrolment in the certificate program Cycle-VI, the completed application form along with Demand Draft of Rs. 20,000/- should be submitted to Program Secretariat - CCEBDM, Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area, Gurgaon-122002, India.

Demand Draft of Rs. 20,000/- should be in favour of "Public Health Foundation of India" payable at New Delhi.

Click here to download application form