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Temporary - BbbhbRegistration - Non Schedule 7A FTP
Temporary - BbbhbRegistration - Non Schedule 7A FTP
Temporary - BbbhbRegistration - Non Schedule 7A FTP
BO AR D O F G O V ER N O R S
IN S U P ER S E S SI O N O F M EDI C AL CO U NC IL O F IN DI A
Po c ket - 1 4, Se ct o r - 8, Ph as e - I , Dw a rk a, N ew D elh i - 1 1 0 0 77
Pho ne : 0 11 - 2 5 36 7 03 3, 2 53 6 70 3 5, 2 5 36 7 03 6,
Em a il : mc i@ bol .n et. i n , W eb sit e : ht tp:/ /w w w .mci ind i a.o rg
2. FATHER’S NAME
(IN BLOCK LETTERS)
3. PRESENT CORRESPONDENCE
ADDRESS
5. NATIONALITY
6. DATE OF BIRTH
1
Form MCI-07 (A)
8. WHETHER THE PRIMARY
MEDICAL QUALIFICATION
POSSESSED IS EQUIVALENT TO
MBBS (MODERN SCIENTIFIC
MEDICINE) OR IT IS IN OTHER
FIELD OF MEDICINE.
9. DURATION OF PRIMARY PRIMARY _________YEARS
MEDICAL AND SPECIALIST SPECIALIST _________ YEARS
COURSE
2
Form MCI-07 (A)
17. DETAILS OF FEES: DETAILS OF DEMAND DRAFT
(a) NAME & ADDRESS OF
AMOUNT IN INR ONLY: ISSUING BANK
...................................................
...................................................
…………………………………………
DATE: ______________
PLACE: ______________
3
Form MCI-07 (A)
APPENDIX-I
INSTRUCTIONS
(i) Name
(ii) Father’s Name
(iii)Purpose for which the draft submitted
(iv) Telephone No with Code/Mobile No.
4
Form MCI-07 (A)
*****
5
Form MCI-07 (A)
Signature _________
Dated ______
6
Form MCI-07 (A)
ACKNOWLEDGEMENT
OFFICIAL
Signature of Receiving Official
SEAL with date
7
Form MCI-07 (A)
APPENDIX-II
To,
Subject: Request for temporary permission u/s 14(1) of the IMC Act,
1956 in respect of Dr…………………
Sir,
ii) He/she will work purely for charitable purpose and not for
monetary/financial gain.
iv) He/she will abide provisions contained in the “Indian Medical Council
(Professional Conduct, Etiquette and Ethics) Regulations, 2002”, while
practicing medicine/performing any kind of surgery in India.