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Printable PDF File - Please click for PDF of Membership application that you can print, complete, and mail with payment.


Last Name   Required  
First Name   Required  
Middle Name  
Is Spouse MD?
Spouse Name    
Address   Required
City   Required  
State Required
Zip Code   Required  
Country Required
Home Phone  
Home Fax  
Office Phone  
Office Fax  
Mobile  
Pager  
Email Address   Required  
Medical College Required
Year Of Graduation Required
Specialty Required  
Private Practice
Academic
University Affliation   
Resident/Fellow  
Position held  
Other Information
Picture
Store as
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Home Address Map  
Office Address Map  
Website Address  
Membership TypeRequired    



       (Reduced Conference Price)
(This amount is non-refundable)
 



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The Mission of OGKMA is to bring together graduates of Osmania University - Osmania, Gandhi, and Kakatiya medical colleges and to function as a venue for charitable, educational and cultural activities that allow members to share common ideas and discuss concerns.