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Medical Computer Society of India
AA-147, Anna Nagar, 3rd Avenue, Chennai - 600 040, India 
www.mcsiindia.net Email : info@mcsiindia.net 
Tel : 044 - 26207000, 26263378/79 Fax : 044 - 26263477 
Membership Form 
 (Please Fill in CAPITALS)

 Full Name *
 Date of Birth *
 Sex * Male Female
 Qualifications*
 Address Line 1*
 Address Line 2
 Pin Code
 City *
 State
 Country *
 Telephone - Hospital / Office
 Fax No
 Mobile Number
 E-mail Address*
 Name and Address of Hospital /
 Company / Institutions 
 Membership Category (for 5 yrs)*
  Individual Organization Students
India / SAARC Rs.1000 Rs.5000 Rs.500
Overseas US $200 US $1000 US $100
  
(Make Cheque / Bank drafts payable to “MEDICAL COMPUTER SOCIETY OF INDIA” & send it to the above address.)
 
 Areas of Interest (please Select one or more)
1.Medical Education 2. Telemedicine
3.Hospital Management Information System 4. IT Healthcare Security / Legal issues
5. Health Portals 6. EMR
7. Imaging Solutions 8. Health Business Solutions
9. Medical Transcription / Call centers / Medical Coding 10.Others
  

Kindly provide 2 references for membership (MCSI members or a person in Good Standing)
 

Reference 1

Reference 2
 Name  Name

 Address		  Address
 Email  Email
 

  

(Please note you will receive an intimation of your membership status within three months of your application)

Benefits of Membership 
  • Concession 10 to 15% during MCSI hosted conferences 
  • Concession 5 to 10% on MCSI supported conferences 
  • Discussion forum membership 
  • Concession of 5 to 10% purchase of Medical Directories, Products, Advertisements on www.medindia.com Medindia 


    (Please quote your membership number when making a purchase. Note - Payment should be made by DD only and not online to avail benefit on purchases)

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