New Store Registration

Apply for KCDA
Membership

For new stores that do not yet have a member ID

Member Distributor

Already have a KCDA ID? Verify here

Name of the proprietor *

Email *

Phone *

Profile Photo

Shop Name *

Storefront Photo

Shop operate 24/7? *

Zone *

Full Address *

Name *

Designation *

Registration Number *

Valid Upto *

Profile Photo *

MD-42 License Number *

Valid Upto *

MD-42 License Document

Upload JPG, PNG, or PDF.

Drug License Number *

Drug License Valid Upto *

Drug License Document

Upload JPG, PNG, or PDF.

Food License Number *

Food License Valid Upto *

Food License Document

Upload JPG, PNG, or PDF.

GST Number

PAN Card Number

Proprietor Aadhar Card Number *

Aadhar Document *

Upload JPG, PNG, or PDF.

Lifetime Registration Fee ₹2,000

Scan & Pay UPI ID: mskcda@sbi Lifetime registration fee: pay exactly ₹2,000 and submit the transaction number.

How to find transaction number

Open your UPI app after payment.
Go to payment history.
Open the KCDA payment entry.
Copy UPI transaction/reference number and paste below.

Transaction Number *

I hereby undertake that all information submitted above is true and correct, and I agree to follow KCDA policies and applicable regulatory requirements. *

Apply for KCDA
Membership

Personal Information

Shop Details

Pharmacist / Component Person

License Information

Payment Details

Apply for KCDAMembership

Personal Information

Shop Details

Pharmacist / Component Person

License Information

Payment Details

Apply for KCDA
Membership