Chikitsak & Candidate Enrollment

Submit your application to join the AYUSH SHUBHAM INSTITUTE healthcare, research, and community medicine network.

1. Candidate Particulars (अभ्यर्थी का विवरण)

Candidate Full Name (अभ्यर्थी का पूरा नाम) *

Father's Name (पिता का नाम) *

Mother's Name (माता का नाम) *

Gender (लिंग) *

Social Category (वर्ग) *

2. Contact & Communication Details (संपर्क विवरण)

Mobile Number (फ़ोन नंबर) *

Email Address (ईमेल पता)

Permanent Residential Address (स्थायी पता) *

3. Course Track or Professional Role (पाठ्यक्रम / पद)

Designation / Training Program *

Registered under Section-8 Central Reg: 188623 • NGO Darpan: BR-2026-1163329. Data submitted is encrypted and audited under statutory guidelines.