Pauls Hospital | Training – 2 weeks course

1st Choice of date :
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First Name :
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Date of Birth :
Residential Address :
Name of Institutions Designation:
Telephone Number:
Mobile Number:
Email:
Degree :

Year :
Institution :
University :
Name of The Institution :
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Designation :
Medical Council Registration Details :
Previous Endoscopy training if any :
Type of endoscopy procedures presently doing :

For Applicants within India(Please Attach a copy of the following)

PG Certificate:

Valid Medical Council Registration :

For Applicants Outside India (Please Attach a copy of the following)

Passport :

Visa :

Medical Registration details :

Report of good standing :

Kindly send the demand draft in favour of ‘Cochin gynecological endoscopic and infertility training centre’ payable at Ernakulam or Bank Transfer

Bank Transfer details
Account Name : Cochin Gynecological Endoscopic and Infertility Training Centre
Bank Name : State Bank of India
Branch Name : Kathrikadavu
Account No : 67258728596
IFSC Code : SBIN0018060
Nature of Account : Current Account
SWIFT CODE : SBININBBT16

Bank Address
SBI
Grand Bay , OPP DD Trade Centre
KattakaraJunction , Kaloor Kadavanthra Road
Cochin -682017
Ernakulam

Postal Address:
Dr. Paul P.G,
Paul’s Hospital, Kaloor, Cochin 682017, Kerala, India
Email: drpaulpg@gmail.com
Ph: 91-484-2344446, 2344447

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