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National Board of elctropathy

New Centre Request

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New Centre Registration

Submit your details to request registration of a new centre. Please provide accurate information and upload the required documents.

Centre Head Details

Enter the personal details of the centre head.

Centre Details

Provide the complete information about the proposed centre.

Documents & Images

Upload the required centre and verification documents.

Only JPG, JPEG, PNG, GIF and PDF files are allowed. Please upload clear and readable documents.
Upload a clear photograph of the centre head.
Image Preview
Centre Head Preview
Upload a clear image of the centre interior.
Image Preview
Centre Interior Preview
Upload a clear image of the centre exterior.
Image Preview
Centre Exterior Preview
Upload valid address proof. PDF is also accepted.
Document Preview
Address Proof Preview
Upload a clear scanned signature image.
Signature Preview
Signature Preview
Registration Information
  • Please ensure that all information provided in this form is correct.
  • Upload clear and valid documents for verification.
  • Centre registration will be subject to verification and approval.
  • Keep your registered phone number and email active for communication.
Fields marked with * are mandatory.