Registration Form

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Dear Ayubian,

As you desired, an interactive form is here to register you and your data to be available to your fellow colleagues on your Institution's Official Website. Please fill the form and submit it for an update of the Ayubian Alumni.

Please do register yourself if you are Ayubian, and note that this page is ONLY for Ayubians' Registration as Alumni.

Please identify and describe yourself as Ayubian:

Full Name:

           Qualification:

Date of Birth (dd-mm-yyyy):

       Year of Graduation from Ayub Medical College:

Gender:

  Male Female

Please provide the following contact information:

Job Position:

  Department:

Organization

 

Street Address

 

City

                  Zip Code:

Country

 

Phone: Office:

   Home:  FAX:

E-mail

   URL:

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Revised: 15 Feb 2014 10:04 AM