Checkout “International membership of HSI (US$100)” has been added to your cart. View cart Billing details 1. MEMBER’S PARTICULARS First name * Last name * Date of Birth Nationality * Gender * Male Female 2. ADDRESS FOR CORRESPONDANCE (RESIDENCE / CLINIC) Addresss * City * State * Pin * 3. CONTACT DETAILS Telephone code * Mobile * Email address * 4. ACADEMIC QUALIFICATIONS Academic Qualification * Medical Registration Number: * Country/State * 5. PRESENT EMPLOYMENT Present Institution Name * Present Designation * City * State * Pin * Image of colour photograph *The photo should not be greater than 1MB Image of educational (surgical) qualification *Image of of educational (surgical) qualifications should not be greater than 1 MB Additional information Order notes Your order Product Subtotal Associate membership of HSI × 1 ₹2,000.00 International membership of HSI (US$100) × 1 ₹8,800.00 Subtotal ₹10,800.00 GST ₹1,944.00 Total ₹12,744.00 Instamojo Pay via Instamojo Since your browser does not support JavaScript, or it is disabled, please ensure you click the Update Totals button before placing your order. You may be charged more than the amount stated above if you fail to do so. Update totals Place order