U.P.Medical Council

NOTE – **ORGANIZATION/ASSOCIATION /INSTITUTE/PROFESSIONAL BODY CONDUCTING THE CME SHOULD APPLY ATLEAST 2 WEEKS IN ADVANCE THROUGH UPMC WEBSITE (www.upmedicalcouncil .org) & UPLOAD ALL REQUISITE DOCUMENTS ONLINE.**

Online CME Application

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Registration No

Date Of Birth

Candidate Details

Certificate No.	:
Name	:
Mother's Name	:
Father's Name	:
Qualification	:
Date of Registration	:
FName	:
MName	:
LName	:

Name of Organization *		Recognition no. of NMC/MCI (If Applicable)
Registration no. of association with its validity date
Name & Medical Registration number of Organising Secretary*
Expected number of delegates*
Place and year of last such programme conducted by the organization*
Topic*
Details of final scientific programme with duration of lectures/programme*
Date of Scientific programme*	Single Day More Than One Day
Venue of Scientific programme*
Email of Organising Secretary*
Mobile No of Organising Secretary*

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