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@if (session()->has('success-message'))
{{ session()->get('success-message') }}
@endif @if (session()->has('error-message'))
{{ session()->get('error-message') }}
@endif
{{ csrf_field() }}
Title
*
Select
Dr.
Prof.
Prof. Dr.
Mr.
Miss.
Mrs.
First Name
*
Middle Name
Last Name
*
Date of Birth
*
Mobile No.
*
@error('mobile_no')
This Mobile Number is already registered for MYMA 2023
@enderror
Email Id
*
@error('email')
This Email id is already registered for MYMA 2023
@enderror
Pursuing
*
Select
M.S.(General Surgery)
Others
Year
*
Select Year
1st Year
2nd Year
3rd Year
Institute
*
Address
*
City
*
Postal Code
*
State
*
Select State
Andhra Pradesh
Andaman and Nicobar Islands
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chhattisgarh
Dadar and Nagar Haveli
Daman and Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Ladakh
Lakshadweep
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Punjab
Puducherry
Rajasthan
Sikkim
Tamil Nadu
Telangana
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
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