RAMCOSA | Member Registration

RAMCOSA (Rangaraya Medical College Old Students Association)

Registered Under Societies' Act 1958 with No. 19/ 1068 with District Registrar / Sub Registrar, East Godavari Dt., Kakinada, Dt.

Fields Marked '*' are Mandatory.

Qualifications:*:

Year of Joining in RMC*:

Admission Number:

Salutation *: Dr Mr Mrs Ms

Name*:

Surname*:

Name in Full:

Primary Mobile Number*:

Whatsapp Number:

Email Id*:

Father Name/Husband Name:

Surname After Marriage:

Gender*:
Male Female

Nick Name / Popular Name in College:

DOB*:

Working As:

Working Sector:*:

Name of the Institution:

Working City/Town:

Working Address:

Address:
Flat Number/Door No.*: Street: Area*: Village/Town/City*: District*: State*: Pin Code/Zip Code*: Country*:

MCI Registration Particulars:
Name of Medical Council*:

Registration Number*:

Educational Qualifications:
MBBS

College Name:

Place:

Diploma

Specialty:

College Name:

Place:

MS

Specialty:

College Name:

Place:

MD

Specialty:

College Name:

Place:

DM

Specialty:

College Name:

Place:

MCh

Specialty:

College Name:

Place:

PDCC:

Fellowship:

Additional Qualification:

Special Interests in Medicine:

Special Interests / Proficiency Outside Medical Field:

Details of National Awards / National Level Qualifications Like Civil Services Posts:

Alternative Mobile Number:

Landline Number with STD Code:

Alternative Email Id:

About Me:

Any Web Link:

Please Upload Your Photo ID:(PAN Card/Aadhaar Card(bothsides) your image

Please Upload Your Photograph Here: your image

Please Upload Your Family Photograph Here: your image

Please Upload Your Work Place Photograph Here: your image

Please Upload Your Friends Photograph Here: your image

I here by declare that I am in full agreement with terms and conditions set by RAMCOSA

**MBBS / PG / Diploma Students of RMC and Who completed PG / Diploma in RMC who enrol for membership are offered membership as Associate membership during which period they will not have any voting rights and cannot contest for any executive posts. They will automatically become Full-fledged Life members after completion of MBBS course and Internship and register themselves with MCI or it's successor body. Date of filling up the application form: DD/MM/YYYY Life members are eligible to receive communications from Ramcosa from time to time and are eligible for 50% discount on Room tariff in Ramcosa House for self and First degree family members.

***Who Completed MBBS at RMC are members of RAMCOSA by default. how ever they need to enrol by submitting details asked here. After approval of the enrolment, they are eligible to Delegate Registration by payment for Ramcosa Reunion 2019. All delegates will become automatically life members for RAMCOSA