NAPCON PG Quiz 2021-22 (Registration Form)
Are you ready to represent your institute at India's Biggest National PG Quiz for Respiratory Medicine Post Graduates & bring GLORY home? Here is an opportunity!!

Please register here only in a pair. Each institute can have only one team comprised of two PG students from any year of the course. Second entry from the same institute automatically disqualifies for the Quiz.

It is mandatory to take the permission of HoD of your institute to participate in the Quiz.

Only MD, DNB & DTCD Post Graduates (PGs) from any year of PG Course can participate. However, DM Pulmo PGs can not participate in this quiz.

Registrations are open from 15th December to 22nd December 2021.
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SECTION A - INSTITUTE DETAILS
Please fill up necessary information about your institute below. It is mandatory to seek the permission of HoD to participate in the NAPCON PG Quiz.
Name of the Institute *
City of the Institute *
State of the Institute (Eg. Kerala, Assam, Delhi etc.) *
Name of HoD *
10 Digits Mobile Number of HoD *
Email ID of HoD *
SECTION B - CREDENTIALS OF PARTICIPANT I
Please fill up your credentials accurately and re-check before submitting. This will be required in future during PG Quiz.
Name of Participant I (As On Govt. Document) *
PG Course Name (MD, DNB or DTCD) *
Year of PG Course (Ist, IInd or Final Year) *
Registration Mobile Number (10 Digits only) *
Registration Email ID *
SECTION C - CREDENTIALS OF PARTICIPANT II
Please fill up your credentials accurately and re-check before submitting. This will be required in future during PG Quiz.
Name of Participant II (As On Govt. Document) *
PG Course Name (MD, DNB or DTCD) *
Year of PG Course (Ist, IInd or Final year) *
Registration Mobile Number (10 Digits only) *
Registration Email ID *
Stay tuned for more details with Cipla Representative or write to napcon.pgquiz@gmail.com. Wishing you all the best!!! May Glory Be Yours!!!
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