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Registration Form | Common Infections in Primary Care
By
Department of Family Medicine
Liaquat National Hospital
Karachi, Pakistan.
Registration deadline : 1st September 2024
* Indicates required question
Email
*
Record my email address with my response
Name
*
Your answer
Father’s/Husband’s Name:
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
PMC/PMDC Number
*
Your answer
Mailing Address
*
Your answer
Mobile Number/WhatsApp Number
*
Your answer
Name and Year of Graduation from Medical College
*
Your answer
Current Designation and Working place
*
Your answer
Payment Mode
*
Cash
Online
Where you heard about us
*
Online search engine (e.g., Google)
Website
Facebook
LinkedIn
WhatsApp group
Alumni referral
Email newsletter or promotional email
Friends, family, or colleagues
Other:
Instruction/Declaration (Please send required documents at
familymedicine@lnh.edu.pk
1. MBBS Degree
2. PMDC/PMC
3.
CNIC
I testify that all the information in this form is correct to the best of my knowledge. I understand that withholding or providing false information will make me ineligible for admission in this course
*
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