Become a Member
PAKISTAN ASSOCIATION OF DERMATOLOGISTS MEMBERSHIP FORM To, The General Secretary, Pakistan Association of Dermatologists. Dear Sir,
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I, Dr. , hereby apply to be enrolled as a Life Member of The Pakistan Association of Dermatologists. I have read the rules and regulations of the Association and agree to abide by them. My Curriculum Vitae are as follows:
LAST NAME
FIRST NAME
FATHER'S / HUSBAND'S NAME
ADDRESS
PHONE Residence
PHONE Clinic
PHONE Hospital
E-mail
MOBILE
DATE OF BIRTH
QUALIFICATIONS
PMDC Reg No.
APPLICANT'S SIGNATURE
PROPOSED BY
SIGNATURE
SECONDED BY
Dr. Sheeraz Ahmed Dawach GENERAL SECRETARY (2023)
PAKISTAN ASSOCIATION OF DERMATOLOGISTS DATA FORM LIFE MEMBER'S DIRECTORY