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APPLICATION FORM - CERTIFICATES REQUEST (STEP 1 OF 3)


 

ACADEMIC DETAILS

REGISTRATION NO *

INDEX NO (MED NO) *

BATCH NO *

FULL NAME *

 

 

CERTIFICATES REQUEST

DEGREE PROGRAMME *

CERTIFICATES *

(Select necessary certificates on the
relevant category)

For MBBS Students

Certificate How to Collect Post / Courier Address

 

For Human Biology / Medical Laboratory Sciences / Nursing / Pharmacy Students

Certificate How to Collect Post / Courier Address

 

 

CONTACT DETAILS

CONTACT NO

E-MAIL *

 

 

ADDITIONAL INFORMATION

IF YOU NEED TO SEND ANY OTHER
ADDITIONAL INFORMATION,
PLEASE MENTION HERE

 

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