Member Registration

Membership Registration Application

Personal Details

Name *

Father's Name / Husband's Name *

Gender *

DOB *

Age *

Blood group *

Email *

Contact No *

HRMS ID No *

Address Details

Current Address

Permanent Address Same as Current Address

At *

Post *

PS *

State *

DIST *

Pincode *

Occupational / Professional Details

Desigantion *

Hospital Type *

Place of Posting *

Date of Joining in Service *

Date of Regularization in Service *

Date of Superanuation *

Name of The Dist (Where Place of Posting is Coming Under) *

Category (Under which Appionted)*

Marital Status

Upload Relevant Documents / Information (Change name of the file Special character not allowed in file name)

HRMS ID Card (only PDF)*

E-Service Book Third Page (only PDF)*

Photo (only JPG)*

Full Signature (only JPG)*

Photo Size must less then 130 KB & Signature Size ust less then 35 KB

Declaration

1. I do hereby declare that the information furnished by me in this format are genuine and if, at any time in future the same will be found forged or manipulated in any manner, that I will be held liable for the consequences as per the decision taken by the Association.
2. I hereby agree to be the bonafide member of the Odisha Pharmacy Officer's Service Association.
3. I further agree to pay regularly the annual membership fee , maintenance Fee and arrear dues etc. and abide by all the existing rules and regulation which may be prescribed by the Association from time to time.