Professional Documents
Culture Documents
No: 08AJAPA7570J1Z8
SUBSCRIPTION FORM
I/WE WANT TO SUBSCRIBE BELOW MENTIONED PRODUCT, PLEASE ACCEPT MY/OUR SUBSCRIPTION
APPLICATION WITH FOLLOWING PARTICULARS
SUBSCRIPTION TARIFF
1 Year 1 Year
(Basic Pack-for 10 (Basic Pack-for 10
4,970 ₹ 5864 ₹ 4,970 ₹ 5864 ₹
experimental experimental
Modules) Modules)
1 Year 1 Year
Experimental Experimental (Comprehensive
(Comprehensive
9,920 ₹ 11705 ₹ Pharmacology 9,920 ₹ 11705 ₹
Physiology Pack -For all active Pack - For all active
Experimental (Ex-Pharm) Experimental
(Ex-Physio)
modules) Series modules)
Series
3 Years Software 3 Years
Software
(Basic Pack-for 10 12,390 ₹ 14620 ₹ (Basic Pack-for 10
12,390 ₹ 14620 ₹
experimental experimental
Modules) Modules)
3 Years 3 Years
(Comprehensive (Comprehensive
25,040 ₹ 29547 ₹ 25,040 ₹ 29547 ₹
Pack -For all active Pack - For all active
Experimental Experimental
modules) modules)
1 Year 1 Year
(Regular Pack) 4,250 ₹
6751 ₹ 7966 ₹ (Regular Pack) 5015 ₹
Checking Limit -
(For Ten dissection
In Queries* Digi-Frog
Plag-Check m0dules)
50,000
Software Software
1 Year
(Advance Pack) 3 Year
14254 ₹ 16819 ₹
Checking Limit - 9,790 ₹ 11552 ₹
(Regular Pack)
In Queries* (For Ten dissection
2,00,000 m0dules)
*1 query means group of words, ending with full stop.
I/We Hereby Enclose the Demand Draft/Cheque/NEFT/RTGS Transaction No. …….…………………… of Rupees ……..……………………………
Dated ……………..………..… Bank & Branch Name ……………………………………… … in favor of “Health Education Bureau”. Payable a Jaipur.
Details of Organization/Institution/Individual ACCOUNT DETAILS
Name of Organization/Institution/Individual ……………………………………………………. Name of A/C: Health Education
Bureau
Mob. No. ………………………………………. Email…………………………………………………….. Name of the Bank: UCO Bank
Account Number:20960210003121
Subscription Year ………………….………………………………………………………………………
IFSC code: UCBA0002096
Address ………………………………………………………………………………………………………... MICR Code:302028023
Bank Branch Name & Code:
………………………………………………………………………………………………………………….. Mansarovar, Jaipur
Branch Code:002096
Dist……………………………………. State………………………………. Pin Code…………………..
District & State: Jaipur, Rajasthan
Place: Date: Signature:
PLEASE SEND US THE FILLED FORM WITH REQUISITE FEES AT FOLLOWING ADDRESS
ADDRESS
HEALTH EDUCATION BUREAU
55/20, Rajat Path, Mansarovar, Jaipur, Rajasthan, India, Pin :302020
Contact: 0141-2783681, 07976447983, 09636348191
E-Mail: support@heb-nic.in, serviceheb@gmail.com
Website: www.heb-nic.in