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: [email protected] 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
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