Register

Lab Incharge's Name

Lab Incharge's Qualification and Designation

Mobile No.(example.9971000000)

Alternate Mobile number

Email Address

Alternate Email Address

Lab name/Department /Hospital name

Complete Address

Landmark

Laboratory District

Laboratory State

Pincode

A brief write-up why you want to join the programme(Max 50 word)

Number of patients investigated daily for blood Counts

No. of Lab Personnel

Control chart preparation method in IQC

Source of standard

Manufacturer Name

Calibration Frequency

Model Name

Model Serial No

Lab Private /Govt. owned/ISHTM members personal labs
---Select Category--- Private Lab Govt. Owned ISHTM members personal labs

Geographical point of your lab address
North-East South North West East

Lab_NABL_NABH
---Select--- NABL Acrredited NABH Acrredited Not Acrredited

Money to be paid

Terms & Conditions: I Have Carefully Read The Instruction & Direction Sheet" Of ISHTM-AIIMS-EQAP And Hereby Declare To Abide The Policies And Procedures Mentioned In It. I Understand That If Any Information Provided By Me Is Found Incorrect Or The Renewal Fees Is Not Submitted Before Deadline, My Registration Can Be Cancelled From The Programme.