Life Membership Form Life Membership Form Please take a moment to fill out the Form Full Name* Gender* MaleFemaleOthers NMC Reg. No. DOB Qualifications University Year MBBS MD Fellowship/DM Others Address Blood Group Contact Phone No. Moblie Office Name* Designation Email Subspeciality Interest Introduced by Dr Introducer's NEPAS Membership No. Photo* Upload png or jpg files, max size: 3 MB. Citizenship Upload png, jpg or pdf files, max size: 3 MB. NMCS Certificate* Upload png, jpg or pdf files, max size: 3 MB. Voucher (Payment Methods) Attach VoucherPay Directly at Office Upload png, jpg or pdf files, max size: 3 MB. NPS Form Upload png, jpg or pdf files, max size: 6 MB.