FORM 16 ( See rule 78 ) FORM OF APPLICATION FOR RENEWAL OF REGISTRATION
To The Registrar, Gujarat Medical Council , * __________________ ____________________
Subject:- Renwal of Registration
Sir, In reply to your notice dated___________ I request That my name may be continued on the Register of Medical Practitioners. The necessary praticulars are given below :-
Full name :- ________________________________________ ( beginning with surname )
Meiden name in case of married women: ________________________ ( beginning with surname )
Registered qualifications with dates of Registration ___________________________
Registration No. _________________
Permanent address for purpose of Registretion _____________________________________
Date
Yours faithfully ,
________________ (signature)
N O T E
(1) This form must be returned duly completedso as to reach the Registrar , Gujarat Medical Council for continuance of registration within forty five days of the date of the notice.
* Here enter full address of the Registrar .
(2) All details shall be correctly filled in .
(3) Applications which do not contain required particuare are liable to be rejected.
(4) Application sent in pursuance of the further notice under clause (b) of section 23 will be accepted only if they accom-panied by a fee of Rs. 2 and sent within thirty days of the date of such futher notice.
