2017 Paed Basic Course Registration form
Name with initials (K.S.S.R. Perera)
Your answer
Name appears on the tag (Kasun)
Your answer
Mobile Number (777628121)( Without initial zero)
Your answer
Your e -mail Address -Please send a email to (paedventilation@gmail.com) to receive the pre-course materials
Your answer
NIC Number (266541645V)
Your answer
Designation
Specialty –
Place of work - Hospital
Place of work - Unit
Province
Number of years you have handled ventilators
Type of ventilator modes being used
Have you been using following brands of ventilators (tick more than one option)
Your meals preference
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