KSMC - Kerala State Medical Council

Please fill out all required fields marked with *

Ensure all information matches your official registration documents.

Registration Details

KSMC / TCMC Registration Number *

KSMC / TCMC Registration Date *

System of Medicine *

Modern Medicine ISM - Ayurveda ISM - Unani ISM - Siddha ISM - Yoga and Naturopathy

Personal Information

Name as in Registration Certificate *

Father's Name *

Date of Birth *

Gender *

Male Female Transgender / Third Gender / Other

Address & Contact Details

Address as in Registration Certificate *

Address Line 1 *

Address Line 2

City *

District *

State *

Country *

PIN Code *

PRESENT CORRESPONDENCE ADDRESS IS DIFFERENT FROM ABOVE ADDRESS

Permanent Address *

Address Line 1 *

Address Line 2

City *

District *

State *

Country *

PIN Code *

Email *

Mobile Number *

Identification

Aadhaar Number

NATIONAL MEDICAL REGISTRATION NUMBER, IF ANY

HEALTHCARE PROFESSIONAL ID (HPR ID), IF AVAILABLE

Basic Qualification

Basic Qualification (as in Permanent Registration Certificate) *

Year of Award of Degree *

University *

College *

Additional Qualifications

These fields are optional. Fill in only if applicable.

Additional Qualification (1)

Qualification

Registration Date

University

Passing Year

Upload Additional Registration Certificate

Upload scanned copy (PDF, JPG, PNG). Max 5 MB.

Additional Qualification (2)

Qualification

Registration Date

University

Passing Year

Upload Additional Registration Certificate

Upload scanned copy (PDF, JPG, PNG). Max 5 MB.

Additional Qualification (3)

Qualification

Registration Date

University

Passing Year

Upload Additional Registration Certificate

Upload scanned copy (PDF, JPG, PNG). Max 5 MB.

Additional Qualification (4)

Qualification

Registration Date

University

Passing Year

Upload Additional Registration Certificate

Upload scanned copy (PDF, JPG, PNG). Max 5 MB.

Practice Details

Place of Practice including Address and Contact Number

Document Uploads

Recent Passport Size Photograph *

Upload a recent passport-size photo (JPG, PNG). Max 2 MB.

Permanent Registration Certificate *

Upload scanned copy (PDF, JPG, PNG). Max 5 MB.

* indicates required fields