Form for issue of NOC - Punjab Dental Council!

Transcription

Form for issue of NOC - Punjab Dental Council!
PUNJAB DENTAL COUNCIL
(S.C.O. 75, [2nd Floor], Sector - 40/C), Chandigarh. (Tel.0172-2693999)
Website: www.punjabdentalcouncil.com Email: punjabdentalcouncil@gmail.com
APPLICATION FOR ISSUE OF NO OBJECTION CERTIFICATE (N.O.C.)
(To be filled in by the candidate)
To
The Registrar,
Punjab Dental Council, Chandigarh.
Subject:
Regarding issue of N.O.C. for ______________________(State) Dental Council).
-0-0-0-
Sir,
I am registered with Punjab Dental Council, Chandigarh, as per
particulars given
below. Kindly issue me N.O.C. for the ____________________
Dental Council. I am surrendering my original Registration Certificate and I-Card/
Smart-Card issued by you:1
Name of Doctor
________________________________________
2
Registration No.
________________________________________
3
Father’s Name
________________________________________
5
Permanent Address
________________________________________
4
Validity of Renewal
________________________________________
________________________________________
Mobile No. __________________ Email __________________________
______________________________
Signature of the Applicant
Mailing Address:____________________________
Dated:____________
_________________________________________
__________________________________________
Requirements:
1. Original Registration Certificate, issued by Punjab Dental Council.
2. Original I-Card / Smart-Card.
3. Fee of Rs.1000/- (+ Rs.50/- as Postal Charges), can be deposited in cash or Bank
Draft favoring “Registrar Punjab Dental Council, Chandigarh”.
4. Renewal of registration should be updated.
5. N.O.C. will be issued after 3 working days.
e/tb dcsoh tos'A bJh (For Office Use Only)
;ko/ ekri w[ew
z b jB.gqtkB j't/ sK n?BHUH;hH ikoh eo fdZsh ikt/ ih.
ofi;Noko
;[govzN

Similar documents

Pdpsmile.com: Best Dental Office in Palatine

Pdpsmile.com: Best Dental Office in Palatine Pdpsmile.com is the best dental office where professional and highly qualified Dentist provides the best dental care solution in the Cook County and Palatine, IL. Best Dentist near me; Call us at 847-358-9700 for any query! Visit our office for the pleasant & professional experience! Visit Us: http://www.pdpsmile.com/

More information