ANDHRA PRADESH MEDICAL COUNCIL: VIJAYAWADA

CME OBSERVER’S FEED BACK FORM

1. Name of the CME/Seminar /

Workshop/Conference/Training
etc.,

2. Name of the Organization /

Association and Place of the
Programme

3. Dates of the Conference

4. Credit Hours allotted by APMC

5. Reference Number of the APMC

for Granting Credit Hours

6. Number of Registered Delegates

7. Name of the APMC Observer

8. Hospitality Provided to Observer

9. Address of the Observer with

Phone Number and E-mail ID

10. Number of Certificates signed as

APMC Observer

11. Number of Certificates issued to

the Delegates by the Observer.

Remarks of the Observer:

Signature of the Organizer Signature of the Observer