Download as pdf or txt
Download as pdf or txt
You are on page 1of 1

2/18/2020 Application Form

MAHARASHTRA COUNCIL OF HOMOEOPATHY, MUMBAI


235 PENINSULA HOUSE, 3RD FLOOR, DR. D.N. RD,Fort Mumbai - 400001 Phone Number 022-22704400/22703086

Application For Renewal / Restoration

Username : rohan28888 Application Print Date : 18/02/2020

Application No : 2007001846
Application Date : 18/02/2020
Amount : Rs. 1600.00/-

Registration No : 62016

First Name Middle Name Last Name


Applicant Name : Rohan Ravindra Solunke
Gender : Male Date Of Birth : 28/08/1988

Contact Details :
Permanent Address :
Address : Gat No.94/1, Plot No.21/a Khote Nagar,
District : JALGAON Taluka/City :
Pin No : 425001 Telephone No : 9420787391
Mobile No : 8424039181 Email Id : rohan.rinku@gmail.com

Qualification Details :
University : MUHS, NASHIK
College : K.D.M.H.M.C. SHIRPUR
Qualification : BHMS Exam Month-Year : May-2012
Internship Period : 08/09/2012 To 07/09/2013
PRN NO :0

I make this declaration solemnly,freely and upon my honour and agree to abide bythe declaration which is displayed on
the website in download form section.

Applicant's signature

https://www.mchmumbai.org/OnlineAppEntryReport.aspx?no=2007001846 1/1

You might also like