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    BMDC Renewal Form2015 PDF

    Uploaded by

    Ferdous
    This document is a renewal form for registration with the Bangladesh Medical and Dental Council. It requests information such as registration number, date of registration, name, address, degrees earned, and payment details. Upon completion, the form allows for renewal of registration with the Council through provision of a receipt number and renewal date.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    BMDC Renewal Form2015 PDF

    Uploaded by

    Ferdous
    860 views1 page
    This document is a renewal form for registration with the Bangladesh Medical and Dental Council. It requests information such as registration number, date of registration, name, address, degrees earned, and payment details. Upon completion, the form allows for renewal of registration with the Council through provision of a receipt number and renewal date.

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    bmdc-renewal-form2015.pdf

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    This document is a renewal form for registration with the Bangladesh Medical and Dental Council. It requests information such as registration number, date of registration, name, address, degrees earned, and payment details. Upon completion, the form allows for renewal of registration with the Council through provision of a receipt number and renewal date.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    860 views1 page

    BMDC Renewal Form2015 PDF

    Uploaded by

    Ferdous
    This document is a renewal form for registration with the Bangladesh Medical and Dental Council. It requests information such as registration number, date of registration, name, address, degrees earned, and payment details. Upon completion, the form allows for renewal of registration with the Council through provision of a receipt number and renewal date.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    BANGLADESH MEDICAL AND DENTAL COUNCIL

    203, Shaheed Syed Nazrul Islam Sarani (86, Bijoy Nagar) Dhaka-1000
    Phone: +880-2-9555538, +880-2-9586727, Fax: +880-2-9555236
    E-mail: info@bmdc.org.bd, registration@bmdc.org.bd
    Website: www.bmdc.org.bd

    RENEWAL OF REGISTRATION

    Registration Number : ………………………………………………………………………………………………


    Date of Registration : ………………………………………………………………………………………………
    Profession & Place of Work : ………………………………………………………………………………………………
    Name : ………………………………………………………………………………………………
    Father's / Husband's Name : ………………………………………………………………………………………………
    Permanent Address
    City/Village : ………………………………………………………………………………………………
    P.O. : ………………………………………………………………………………………………
    P.S./Upazila : ………………………………………………………………………………………………
    District : ………………………………………………………………………………………………
    Postal Code : ………………………………………………………………………………………………
    Telephone No. : ………………………………………………………………………………………………
    Present Address
    City/Village : ………………………………………………………………………………………………
    P.O. : ………………………………………………………………………………………………
    P.S./Upazila : ………………………………………………………………………………………………
    District : ………………………………………………………………………………………………
    Postal Code : ………………………………………………………………………………………………
    Degrees (Medical)
    Basic Degree : ………………………………………………………………………………………………
    Post-Graduate Degree/Diploma (If Registered with Bangladesh Medical & Dental Council)
    ............................................................………………………………………………………………………………………………

    Pay Order / D.D. No. / Cash ............................. Date ................................. Signature ………………………

    For Office Use :


    Renewal Fee Tk. ……………………… Receipt No. ………………….. Date: ……………………………
    Late Fee Tk. ……………………… Receipt No. ………………….. Date: ……………………………
    Urgent Fee Tk. ……………………… Receipt No. ………………….. Date: ……………………………
    Renewed Upto : ………………………

    Signature

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