Dear Colleague, 

To start with, here is a brief introduction to Endometriosis Society, India for you, if you are not a member of it or you are not acquainted with this society.
Endometriosis is emerging as a serious global problem with all of its medical, economic and social impacts to women and the society. Endometriosis Society, India has been established in 2003 with a view to conduct research, education, training and awareness about this disease among the medical fraternity and rest of the society. It has organised its first National Congress at Kolkata on December 10-12, 2004 in collaboration with RCOG, Eastern Zone, India where more than 300 delegates had participated. It has also conducted live workshops on endometriosis surgery and public awareness programmes.
We have now planned to conduct a survey on the Indian scenario of endometriosis. As the initial step, we are sending a questionnaire (enclosed herewith) to you. Please spend some time from your busy schedule and send it to us through the self-addressed stamped envelope after filling it up.
May I take this opportunity to request you to become a life member of Endometriosis Society, India (if you are not already one of us)?

Thank You,
Sincerely Yours,

Mr. P. Das Mahapatra

Founder Secretary General 

Endometriosis Society, India 




6A & 6F, NEELAMBER, 28B SHAKESPEARE SARANI, KOLKATA- 700017. PHONE: 033-2865-0364, 2240-4463, FAX: 033-2281- 1639, e-mail: endomet_soc_india@, web site:
1. Name :  Dr.
2.  Qualification :   
3.  Registration No. :   
4. Are you a member of Endometriosis Society, India?
5. Any special area of interest    :   

Name of City / Town / Village where you practice most of the time

7.  Field of Practice:   Teaching Hospital                              
      District / Sub-Division / CHC / PHC 
      Corporate Hospital /Nursing Home
      Personal Clinic /Nursing Home       
  Others (Please Specify)                     :   

How many endometriosis cases have you personally seen in the last 3 months :

How many of them had associated infertility   :
3. How many of them were teenagers? :   
4. What is commonest age group of presentation?            :
20 20-25 25-30 30-35 35-40 40-45


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