IPA — Indian Pharmacist Association | Strengthening the Pharmacy Profession

+91 98798 45783

info@ipa-gujarat.in

70, TALAV FALIYU, AT PO: PANIYA, TA LIMKHEDA, DIST DAHOD, PIN 389140

Full Name *

Father's Name *

Phone Number *

Email *

Date of Birth *

Gender *

Blood Group

Designation

GSPC Certificate Number or I-Card Number*

Address *

Pincode *

Attachments *

1. GSPC Certificate or I-Card *

Upload your GSPC (Gujarat State Pharmacy Council) Certificate or i-card (< 5MB file)

2. Aadhaar Card *

Upload a clear copy of your Aadhaar Card (front and back) (< 5MB file)

IPA Member