Council of Homoeopathic Medicine, West Bengal

Doctor's & Student's Application Portal

Welcome! Start by selecting the reason(s) for your application, and the form will show you exactly what information is needed.

Instructions : After final submission of the online application form, one print out of the online application form & online payment receipt must be sent along with the “Original Doctor’s Registration Certificate” / " Original Police Missing Diary" for Duplicate Registration / "Affidavit of First Class Judicial Magistrate" for Corrections of Name or Surname / "Original Declaration of Head of the Institution or Hospital Superintendent" for Provisional Registration Certificate to Council of Homoeopathic Medicine, West Bengal via Speed Post / Physically to the following address : The Registrar, Council of Homoeopathic Medicine, West Bengal, 9/1B, Mahatma Gandhi Road (1st Floor), Kolkata - 700 009.

Select Reason for Application

Important: Please select one or more reasons below. The form will automatically show you the required fields and documents based on your selection.

Change of Surname

Change of Address

Request for Duplicate Certificate

Retention of Registration

Entry of Additional Qualification

Cancellation of Registration

Request for Doctor's Identity Card

Application for Provisional Registration

Personal Information

Name

Father's name

Address

District

Pincode

Police Station

Aadhaar Number

Date of birth (DD/MM/YYYY)

Blood Group

Contact Information

Mobile Number

E-mail ID

Academic & Registration Information

Registration number

Date of registration (DD/MM/YYYY)

Name of the Qualification

Examination passed with subject

Held In (Month & Year of Degree)

Name of University

Name of College

Document Uploads

Please upload the required documents from original & in colour format based on your selected application reasons. Accepted formats: PDF, JPG, PNG. Maximum file size varies per document type.

Select Application Reasons

Document upload fields will appear based on your selection

✅ Save Draft

Please review all information carefully before saving. Once saved, this application will remain in draft status so you can preview it and continue editing.

🔒 Your information is secure and will be processed confidentially