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Specialist Registration
First Name   
Middle and Last Name  
User Name    
Password  
Confirm Password   
Date of Birth (DD/MM/YYYY) /
Sex
Professional Qualification / Acadamics  
(Please Mention also the year of Qualification)
Registration #  
(PMDC Reg. No. for Pakistani doctors)
Current Appointment.  
Address  
City  
Country
Zip Code    
Phone 1    
Phone 2  
Email    
Consultancy Fee $    ( 1$=69 Rs/ )
Speciality  

- Other Specilities (if not listed above):

Please send us a copy of your CV and Degree either in soft or hard form for verification.