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  • استمارة التسجيل

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    mulliganjeddah
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    This document is a registration form for a Mulligan Approach workshop for cervical and upper quadrant treatment to be held in December 3102 in Jeddah, Saudi Arabia. The form requests the participant's name, hospital position, address, contact information, and payment details. There are early and late registration fees of 0111 SR and 3111 SR respectively, and payment can be made by cash, cheque, or bank deposit. The completed form and proof of payment should be faxed or paid in person at the center. Contact information is provided for inquiries.

    Original Description:

    استمارة التسجيل في دورة المعالجة بطريقة مولغان

    Original Title

    استمارة التسجيل (1)

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    This document is a registration form for a Mulligan Approach workshop for cervical and upper quadrant treatment to be held in December 3102 in Jeddah, Saudi Arabia. The form requests the participant's name, hospital position, address, contact information, and payment details. There are early and late registration fees of 0111 SR and 3111 SR respectively, and payment can be made by cash, cheque, or bank deposit. The completed form and proof of payment should be faxed or paid in person at the center. Contact information is provided for inquiries.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    18 views1 page

    استمارة التسجيل

    Uploaded by

    mulliganjeddah
    This document is a registration form for a Mulligan Approach workshop for cervical and upper quadrant treatment to be held in December 3102 in Jeddah, Saudi Arabia. The form requests the participant's name, hospital position, address, contact information, and payment details. There are early and late registration fees of 0111 SR and 3111 SR respectively, and payment can be made by cash, cheque, or bank deposit. The completed form and proof of payment should be faxed or paid in person at the center. Contact information is provided for inquiries.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    Medical Physical Therapy Center

    REGISTRATION FORM
    Mulligan Approach for Cervical and Upper Quadrant
    form with payment slip.
    Title:
    DR. Prof

    Month Dec.

    Days 32-32

    Year 3102

    City
    Jeddah

    Please fill CLEARLY ALL INFORMATION in BLOCK LETTERS (for certificates) and return this

    Mr.

    Ms.

    Other.

    Male

    Female

    FIRST NAME MIDDLE NAME FAMILY NAME HOSPITAL POSITION ADDRESS

    CITY: CONTACT INFO: PHONE NO FAX NO E-MAIL:

    P.O BOX: EXT.#.(if any) EXT.#.(if any) MOBIL NO:

    COUNTRY:

    REGISTRATION FEES: (Payment must be received by deadline date) 0111 SR for early registration before21/00/3102 3111 RS for late registration - CASH: MEDICAL PHYSICAL THRAPY CENTER - DEPOSITE IN THE NATIONAL COMMERCIAL BANK ACCOUNT ((65660677555665)) - CHEQUE BY THE NAME OF THE MEDICAL PHYSICAL THRAPY CENTER

    Ea

    N. B.
    THIS FORM WILL BE SENT AFTER FILLING IT TO FAX.(2699+99950++6) EXT.(659) WITH COPY OF DEPOSITE OR YOU CAN PAY IN CENTER

    FOR FURTHER INFORMATION PLEASE CALL US ON (231110019) EXT. (010&011) MOB. 1110210021 E-MAIL: aymanhelal_3110@hotmail.com

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