Registration form

•

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faculty of medicine -Tanta university

Education Health & Medicine

Emara's Toxicological award
Registration Form

January 21, 2012

____________________________________
Name (Last, First, MI)
____________________________________
Organization
____________________________________
Address
_________________________________________________________________________
____________________
Born in
Email

For more information about the award, please contact
Ashraf M. Emara, M.D., Professor
Forensic Medicine and clinical Toxicology department
Faculty of medicine
Tanta University
Mostafa7005605@yahoo.com

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