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. :iii., . COLLEGE OF PHYSICIANS DISSERTATION DATA SHEET

~ AND SUR.GEONS PAKISTAN
(FOR WARO/INPA TIENTS ONL Y)
•

Title of Dissertation (Plea.. t'll in Capital letter ,: _ __ __ __ _ _ _ _ _ _ __ _ _ __ _ __ __ __ _ __ __ _ __ _ __ __ _ __ __ _ __ _ __ _ __ __ _

Name of Candidate RTMC Reg. #:

Specialty: Date of Passing FCPS I:

Date of approval of Synopsis: Date of submission of Dissertation:

Details of Ward/lnpatients* (Exact Name. and Institution):

--- --- - - --- - -- --------------------------------------------------

IMPORTANT NOTE
* Exact source I.e. the name and number of Ward should be given.
- If name of the patient is not gIven provide valid reason.
Signature of Candidate: _ _ __ ______ _ __
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COLLEGE OF PHYSICIANS DISSERTATION DATA SHEET

• AND SURGEONS PAl<lSTAN

(FOR WARO/INPA TlENTS ONL Y)
Continuation Sheet

Signature of Candidate: