E-signed Declaration Health Care Professional

Personal Details:
Name: Hichir Bage
HPR-ID: 71-1626-2677-7546
Professional Type: Nurse
Sub Category: Registered Nurse and Registered Midwife (RN & RM)
Mobile No: 9755088943
Email-Id: hmonikab88@gmail.com
Salutation: Ms
First Name: Hichir
Middle Name:
Last Name: Bage
Nationality: Indian
Languages Spoken: Hindi , English

Communication Address:
Name: NA
Address: BMC MEDICAL COLLEGE SAGAR
Country: Indian
State: Madhya Pradesh
District: Sagar
City/Town/Village:
Postal code: 470002
Have you shared your Phone no for public: Yes
Mobile No: 9755088943
Have you shared your Email-Id for public: YES

Registration Details:
Registered with Council: Madhya Pradesh Nurses Registration Council
Registered Number: AI-17865DII-17214
Registration Date (if Available): 27/11/2011
Registration: Renewable
Due Date Of Renewal: 28/06/2026
Qualification Details:
Name of Degree or Diploma: Bsc Nursing
Country Name: India
State Name: Madhya Pradesh
College Name: Cmtc College Of Nursing , Damoh Mp
University Name: Dr. Harising Gour Vishwaidyalaya Sagar ,m.p

Work Details:
Currently Working: Yes
Nature of Work: Practice
Working With: Private Practice only

Facility Details:
Facility ID Facility Name Address State District Type Departm Designat Status
Status ent ion
NA NA BMC BMC Madhya Sagar Governm PEDIAC NURSIN DECLAR
MEDICAL MEDICAL Pradesh ent TRICS G ED
COLLEGE COLLEGE OFFICE
SAGAR MP R

Declaration
I hereby declare that I am voluntarily sharing above mentioned particulars and information. I certify that the above
information furnished by me is true, complete, and correct to the best of my knowledge. I understand that in the event
of my information being found false or incorrect at any stage.

Name: Hichir Bage

Healthcare Professional ID Number: 71-1********-7546
Digital Signature:
Digitally signed by
Date: 2024.04.18 19:49:43 IST
Reason: HPR Registration
Location: NHA