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Title

Select Rev Prof Dr Mr Mrs Miss

Name with Initials

Name to be printed on the Certificate

NIC or Passport No

Email

Mobile No ( 71XXXXXXX format only - without leading 0 )

Participant

Select Council member Delegate Resource person

User Category

Select Medical Officer Consultant

Bank Transfer

Online

Upload Payment Slip *

Register

Bank Details

Bank : BOC NCK Branch
A/C Name: The Kandy Society of Medicine
A/C Number : 31624

If the ONLINE payment failed, you can try it again with filling your details.