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  • Inner Circle - Program Request

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    Pradeep Kumar
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    This document is a program request form for an educational event. It requests information from the requesting doctor or institution such as their name, contact details, number of recommended participants, proposed date and venue, and authorized signatory. The form provides spaces for the number of recommended and actual attending participants to be filled in by the Dr. Reddy's Foundation for Health Education (DRFHE) for their records.

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    Inner Circle_Program Request

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    This document is a program request form for an educational event. It requests information from the requesting doctor or institution such as their name, contact details, number of recommended participants, proposed date and venue, and authorized signatory. The form provides spaces for the number of recommended and actual attending participants to be filled in by the Dr. Reddy's Foundation for Health Education (DRFHE) for their records.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    10 views1 page

    Inner Circle - Program Request

    Uploaded by

    Pradeep Kumar
    This document is a program request form for an educational event. It requests information from the requesting doctor or institution such as their name, contact details, number of recommended participants, proposed date and venue, and authorized signatory. The form provides spaces for the number of recommended and actual attending participants to be filled in by the Dr. Reddy's Foundation for Health Education (DRFHE) for their records.

    Copyright:

    © All Rights Reserved
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    of 1

    PROGRAM REQUEST

    Please attach
    Visiting Card

    Name of the Doctor/


    Institute : ______________________________________________
    the inner circle

    Mobile No. : ______________________________________________

    E-mail ID : ______________________________________________

    Address : ______________________________________________
    ______________________________________________
    ______________________________________________

    No. of participants
    recommended : ______________________________________________

    Proposed Date & venue


    of the program : ______________________________________________

    Authorized Signatory
    Doctor / Institution : ______________________________________________

    Name of SBO / ASM : ______________________________________________

    For DRFHE use only


    No. of participants
    recommended : ______________________________________________

    No. of participants
    attended : ______________________________________________

    You can write to us at:


    drfhe@drreddys.com This program is supported by an
    unrestricted educational grant from

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