ID card by ajizai

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									                            ANDHRA PRADESH
                     GOVERNMENT DOCTOR’S ASSOCIATION
                           Behind E.N.T. Hospital, Koti, Hyderabad – 500 095
                                        Phone : 040-24744286
                                                                                      PHOTO
                                    I.D. CARD PROFORMA


Dr.Name: ________________________________________________________________________________________

Designation: _____________________________________________________________________________________

Father’s/Husband’s Name: _________________________________________________________________________

Membership No. & Date: __________________________________________________________________________

Date of Birth: ____________________________________________________________________________________

Blood Group: ____________________________________________________________________________________

Original Unit: ____________________________________________________________________________________

Present Unit: _____________________________________________________________________________________

Address: _________________________________________________________________________________________

        _________________________________________________________________________________________

								
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