Register AOP AHMEDABAD Register AOPA MEMBERLife Membership₹1,000.00BECOME A MEMBER – FOR PEDIATRICIANS ONLYNOTE : - If you are a CIAP MEMBER & have a permanent resident in Gujarat, you can become AOP Ahmedabad member by registering with the form below and paying Rs. 1,000/- life membership fee. - Fill all the details as per records in CIAP for verification. - Once your details are verified, your account will be activated. After that, you will able to log in to your account. - For any query you can contact us on aopahmedabad@gmail.com REGISTRATION FORM All fields marked with * are mandatory to enter * Mobile Number (Username)Allow only 10 digit * Surname * NameGenderMaleFemale * Date of Birth * Email Address * Confirm Email Address * PasswordStrength: Very Weak * Hospital Address * Residential Address* StateGujarat * State * City * Pincode * CIAP NumberProfile PictureDrop file here or click to select.jpg, jpeg, png / Max 5 MB Select Your Payment GatewayRazorpayHow you want to pay?Auto Debit PaymentManual PaymentPayment SummaryYour currently selected plan : , Plan Amount : Final Payable Amount: PAY NOW Already have an account? Login
