• Membership Selection

  • Personal information

  • Address

  • Qualification

  • Recommendation

  • Declaration

Membership Selection

Membership Category

Select one from the following

Upload DM/ DNB Certificate *

It is mandatory to upload the certificate
Format: PDF, JPG, JPEG, PNG
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Board Certification

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Upload board certificate, if any
Format:PDF
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Personal Information

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This field is required
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Upload your passport photograph
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Address

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Qualification

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Please mention your universities and year

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Add University

Training in Cardiac Electrophysiology/ Pacing

Required

Please mention your experience in years and months for Cardiac Electrophysiology / Pacing

Present Appointment

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Recommendations

Please enter details of two proposers from existing members of IHRS and also send a request to respective member to confirm your recommendation.

Proposer 1

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Proposer 2

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Declaration

I,
Hereby solemnly and sincerely declare that, to the best of my knowledge and belief, the above particulars given by me are true and correct. In case if any of the above information is found to be incorrect, it may lead to cancellation of my membership
I Declare