Registration for the PGIM Examiner Training Programme - September 2018
Postgraduate Institute of Medicine
12th & 19th September 2018
1. Name (as it should appear in certificate): *
Your answer
2. Email address: *
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3. SLMC No: *
Your answer
4. Board of Study/Specialty Board:
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5. Specialty: *
Your answer
6. Date of the Board Certification: *
Your answer
7. Telephone No: *
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8. Work place: *
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9. Postal address: *
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10. Confirm your participation for the following dates
Module 1
Module 2
Meal Preference *
Thank you!
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