| FORM"D" [see Rule 3(a)] State Homoeopathy Council Madhya Pradesh (SEAL) CERTIFICATE OF REGISTRATION |
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REGISTRATION NO............................................................................................DATE......................................... CERTIFICATE is granted that shri/Ku./Shrimiti...................................................................................................... Son/Daughter/wife of......................................................................................Resident of................................... .............................................................................................................District................................................ of Madhya Pradesh has been duly registered as a registered as a registered Homoeopathy Practitioner under Section 22 of the Madhya Pradesh Homoeopathy Parishad Adhiniyam,1976. CERTIFIED that the name of the practitioner has been continued in the State Register of Homoeopathy and the Certificate has been renewed on................................................./re-entered. In witness where of are herewith affixed the signature of the Registrar and Seal of the Council. (Seal)
(The Practitioner registered with the Council is expected to inform immediately any change in this residential/professional address,appointment in Government Service,acquir additional qualification. The name from the State Register of Homoeopathy shall be removed without notice if falled to apply for renewal and continuation of name in the State Register of Homoeopathy). |
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