@if(session('error'))
@endif @if(session('success'))
@endif @if (sizeof($errors) > 0)

@foreach ($errors->all() as $error)
• {{ $error }}
@endforeach

@endif

Registration Form

@csrf

Doctor’s Name

Date of Birth

Gender

Male

Female

@include('partials.register-whatsapp-field')

Alternate Contact Number

Email* (Frequently Used)

@include('partials.register-location-fields')

Qualification

Select MBBS PG Student UG Student MD DNB DCh CPS Others (Please Specify)

Other Qualification

Specialty of Practice/Work

Select Pediatrics General Medicine Pulmonology Others

Other Specialty of Practice/Work

Designation

Name of the Institute

I hereby give consent to receiving further communication from CREST for academic and research purposes

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