Doctor Registration – ASSESS-GASTRO Study

An Observational Study on the Safety and Effectiveness of Standard Care Therapies in Paediatric Patients with Gastrointestinal Disorders: Real World Evidence in Indian Paediatric Settings (ASSESS-GASTRO)

Name of the Doctor

Clinic / Hospital Address (with Pincode)

Upload PAN

(JPG, JPEG, PNG, PDF).

Upload Aadhar

(JPG, JPEG, PNG, PDF).

Upload Cancelled Cheque

(JPG, JPEG, PNG, PDF).

Email Address

Mobile No.

Bank Details

Bank Name

Bank Account No.

Branch Name

IFSC Code

By submitting this registration form, you acknowledge that all information provided is true and correct to the best of your knowledge. You consent to the collection, use, and storage of your personal information in accordance with our Privacy Policy.