Kerala State
Pharmacy Council

A STATUTORY BODY CONSTITUTED UNDER SECTION 19 OF
PHARMACY ACT 1948 (CENTRAL ACT)

Registration

Candidates are advised to go through the instructions ( English | Malayalam ) carefully before filling up the online application form. Incomplete applications will not be considered for registration.
Name *
(Same as in the SSLC Certificate)
Father's Name *
Place of Birth *
Date of Birth *
 
Blood Group *
Address*
Pincode *
State *
District *
Nationality *
Phone Number (with STD code)
Mobile Number *
Email Id *
ID Proof *
Upload your Colour Photo * [Width:150px Height:200px Max Size:30Kb
Allowed Extension: jpg,jpeg]
Upload your Signature * [Width:150px Height:100px Max Size:30Kb
Allowed Extension: jpg,jpeg,png]
 Whether transfer from other state?
Course Period
Training State   Kerala     Other State
Name of Training institution
Training Period
     
Details of the Trainer
Amount * Payment Mode * Payment Through*
  I hereby agree that the amount of Rs. 1000/- (is for 10 years) for Voluntary Non-refundable deposit for renewal fee is also included in the amount of Rs. 2600/- I paid in favour of the Register, Kerala State Pharmacy Council, Thiruvananthapuram-35. In further, if due to some reasons this amount become inadequate to cover my renewal fee, I shall remit such additional amount as you may deem fit under section 34(1) of the Pharmacy Act 1948.