First Aid Warrior Registration

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Profile Photo *

JPG / PNG, max 2MB — required

Upload Camera

Full Name *

Email *

Mobile *

Gender

Qualification *

Specialization

Experience (years)

Current Workplace

Nursing Registration Number *

State Council Registration Number

Training Doctor UID * (must be an active verified doctor)

Address

State *

District *

Mandal / Taluk

Village

Pin Code

Required

Verification Documents (PDF / JPG / PNG, max 2MB — all required)

Registration Certificate *

Choose file

Degree Certificate *

Choose file

Experience Certificate *

Choose file

Government ID *

Choose file

I confirm that I am currently working / training under the registered doctor whose UID is entered above, and the information provided is true.