General Information
My Membership |
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Membership Number |
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Date of Birth |
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Age |
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Gender |
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Mobile Number |
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Father's Name |
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Nationality |
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Current Practice Title |
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Work Experience |
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Awards |
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Medical Council Registration
MCI Registration (MCI/State Medical Council Number) |
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Authority (MCI/Name of State Medical Council) |
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IMR Registration Number |
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Is ASI Number |
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No
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ASI Registration Number |
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ASI Registration State |
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Any Other International Organizations
International Organizations |
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Other International Organization Name |
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Qualifications
Qualification Name |
Degree |
College |
University |
Years of Passing |
Current Endoscopic/Laparoscopic Experience
Procedure |
Experience (in years) |
No of Procedures (past 1 year) |
No of Procedures (past 5 year) |