Indian Institute of Alternative Medicines 80, Chowringhee Road, Calcutta-700 020 Affiliated with INDIAN BOARD OF ALTERNATIVE MEDICINES
Health Sciences Journal Subscription form
Name:
Date of Birth:
Sex:
Nationality:
Mailing Address Street:
State:
City:
Country:
Pin / Zip:
Telephone:
Fax:
E-mail:
Website:
Currency:
Payment Details:-Bank Name:
Payment Mode:
No:
Dated:
Amount:
Registration / Roll No.(if any) of Indian Board of Alternative Medicines:
Note:Payment should be in the name of "Health Sciences Journal" 2/1A, Dr Rajendra Road, Calcutta-700 020, India
Please review the form thoroughly before pressing the SEND button.
home