NIGERIAN HEALTH WORKERS DATA COLLECTION TOOL
This form is for the practitioners. PLEASE MAKE SURE THAT ALL INFORMATION PROVIDED ARE ACCURATE paying close attention to BOARD NUMBER, DATE OF BIRTH, AND IDENTIFICATION DETAILS.
OPTOMETRISTS AND DISPENSING OPTICIANS REGISTRATION BOARD OF NIGERIA.
Please note:
All duplicate answers would be deleted, contact ODORBN for instructions on how to correct any mistakes.

On behalf of the ODORBN Management and the Federal Ministry of Health we would like to thank you for your time.
Deadline for this form is the 30th of Nov, 2018.

INDIVIDUAL HISTORY
SURNAME *
Your answer
FIRST NAME *
Your answer
OTHER NAME
Your answer
PHONE NUMBER *
Your answer
MAIDEN NAME
Your answer
BOARD NUMBER *
Please, make sure that Practitioner Board Number appears as it is on the Practitioner's License. e.g: Newer Board ODORBN/0123/4567 (with last number group being the year of first license)
Your answer
ALTERNATE NUMBER
Your answer
Email *
Your answer
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