Diploma in Panchabhautik Chikitsa DPCH Online form

    Section A - Course selected


    Section B - Personal information

    First Name*
    Middle Name

    Sur Name*
    *Name as it should appear on the certificate


    Date of Birth*

    Section C - Contact information

    Address 1*

    Address 2*




    Phone number

    Mobile number*

    Alternate mobile number(relative or friend)

    Email id*

    Alternate Email id

    Section D - Academic qualification


    Name of the institute*


    Year of passing*

    Section E -Upload supporting documents

      *Upload document in given format only - jpg, jpeg, png, bmp, pdf. Upload image size upto 2MB per image.

    • Degree certificate / Pass certificate*
    • Proof ID* (Pan card / Aadhar Card / Voting Card / School Bonafied)
    • Proof of address* (Aadhar Card / Voting Card / Light Bill / Phone Bill / Driving Liecense)
    • CCIM / State council / Provisional registration*
    • Photo*

    Section F - Preferred Payment mode*

    Cash deposit in Sangli OfficeChequeBank transferDemand Draft

    Section G - Declaration

    I hereby confirm that the information I have provided on this application form is (to the best of my knowledge) true, accurate, current and complete; and I agree to notify VDPCK promptly if any information contained on this application form should change, in order to keep it true, current and complete.

    I hereby declare that I shall be disciplined and shall adhere to all the rules and regulations of VDPCK. I have read and fully understood the terms and conditions” given overleaf before filling in the
    application form and unconditionally accept them all binding on me.

    I hereby undertake to pay all charges raised on account of services availed.

    agree to all terms and conditions

    Instructions -

    • Please fill the form completely and furnish all details required there in.
    • Please upload all the relevant documents and photo in jpg format.
    • All disputes with regard to this course are subject to the jurisdiction of sangli.
    • Online payment should be done using "payment" button.
    • Cash payments are not accepted and VDPCK is not responsible for any cash payments made.

    Terms and conditions

    • Certification of course completion would be awarded only after payment of full fee and successfully passing the final examination.
    • VDPCK reserves the right to disqualify a candidate for providing false information, submitting improper documents or for misconduct in a particular course.
    • VDPCK reserves the right to revise/change the curriculum, the course structure or course delivery methodology without prior notice.
    • Fees once paid will not be refunded. Fee transfer to other person is not entertained in any circumstances.
    • The payment will be refunded completely if the applicant is not selected for the program.
    • The application form will be processed only after payment is realized / received by VDPCK.
    • Candidates shall be eligible to attend contact program only after full payment of fee and completion of lecture and live sessions schedule.
    • Contact programs shall be conducted in batches and therefore may not start immediately after completion of study modules. This may result in extended duration of the entire course.
    • Candidates shall be informed about the dates of contact program in advance. Once intimated, it is necessary for the candidate to attend the contact program.

    I have read, understood, agree and abide by the terms and conditions lay down by VDPCK

    Course fee - Rs. 18000 only. (Includes course material, live audio sessions, permission to clinical experience for 7 days at main clinic and contact program with accommodation and meals)

    Comments are closed.