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Gastro(30-July-2025)CME Registration Form - Continuing Medical Education
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Basic Information
First Name
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Last Name
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Specialty
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Designation
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Qualification
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Institution
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Mailing address
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City
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Country
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CNIC No
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LNH employment No
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Passport No. (Optional)
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PMDC Registration No
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Email Address
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Phone No
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Title of the Activity
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Name of Organizer/Planner
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Type of CME activity
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Online
In-Person
Payment details
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Payment Option
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Bank Challan
Pay order
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Name of Bank
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Challan/Draft No
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Date
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