CDD

Corporate Registration

Organization Name:

Type of Organization:

Establish Date:

Organization Address:

REGISTRATION Number:

Upload REGISTRATION CERTIFICATE

(in Image Format eg. .jpg, .tiff file - max 100kb size)

Are you Member of SSBTR?

If YES upload Membership Registration (in Image Format); if NO please Contact Us

(eg: .jpg, .tiff file - max 100kb size)

Enter your valued email id and mobile number, as confirmation will be sent to this Id and mobile no. and this will take atleast 10-15 days

I /we understand that the data may be publicly avaialable / displayed without disclosing patient's identity and if any identity is disclosed by any Report/ Image/ Diagnostic document then the CD2 is not responsible and I/we do data entry as par patient's consent for this

I Agree by the the terms and condition ........

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All field are mandatory to complete the registration