APPLICATION FOR THE RENEWAL OF REGISTRATION THE REGISTRAR

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Maharashtra Medical Council Anand Complex,
2 Floor, Sane Guruji Marg,
Arthur Road Naka, Mumbai - 400 011.






Sir,
I the undersigned applicant, request you that my name may be continued on the Register of Medical Practitioners maintained by the Maharashtra Medical Council as per 23 (a) / 23 (c) of MMC Act 1965 and amendment 2003. My particulars are as under :-


Name of the Applicant (Beginning with sumame in capital Letters )


Father/Husband's Name


Mother's Name






Details of Qualification



I enclosed herewith attested photocopies of following documents :
1. Photocopy of the Certificate of Registration of Maharashtra Medical Council.
2. Demand Draft / Pay Order favouring Registrar, Maharashtra Medical Council Payable at Mumbai.
3. Xerox copy of MMC I-Card.
4. Three copy of Latest passport size Photograph.
5. C.M.E. Credit Hours (Please 500 notice on website - http://maharashtramedicalcouncil.org)
6. Attested Xerox copies of CME Certificates Showing Credit Hours.


Declaration I shall abide by the Code of Medical Ethics as enunciated in the Indian Medical Association (Professional Conduct. Etiquette and Ethics) Regulations, 2002.


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