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Short Course Registration
Prime Institute of Public Health
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Nature of the Activity for which the registration is ought *
Are you a *
Full Name (As you want it on the certificate) *
Father/ Husband's Name
CNIC Number (Use dashes e.g. 12345-1234567-1) *
PMDC Reg. Number (For Doctors only)
Institutional Designation (if any)
Affiliated Department and Institute/Hospital (if any)
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