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Nepal Medical Council
Bansbari, Kathmandu
Tel : +0977-01-4377164/4371954
Application for Registration Status (Certificate of Goodstanding)
Name:_____________________________________________________________________
Date of birth : (AD) Year ______ Month ____ Day ___ (BS) Year ______ Month ____ Day ___
Sex : Male Female NMC registration No. : _________ Mobile No. _________________
Email address :_____________________________________________________________
Date of temporary registration (AD) Year ______ Month ____ Day ___
Date of permanent registration (AD) Year ______ Month ____ Day ___
Highest academic qualification: _____________________ Specialty ___________________
Current employer : __________________________________________ Since ___________
Reason for application : _______________________________________________________
Organization intended to submit registration status :________________________________
Undergraduate study scholarship or bond : Yes No If Yes, release letter.
Postgraduate study scholarship or bond : Yes No If yes, release letter.
Applicant's signature : __________________ Date : _______________
Checklist for application :
1) Duly filled application form 2) Photocopy of Temporary/Permanent/Specialist registration
3) Bank voucher/eBanking of Rs. 1,000 for Nepalese & Rs. 2,000 for Foreigner. Nepal SBI Bank
Account Name Nepal Medical Council, A/C No. 2043 5240 1000 22 OR Rastriya Banijya Bank
Account Name Nepal Medical Council, A/C No. 1150 1000 0233 1001
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– g]kfn d]l8sn sfplG;naf6 hf/Lx'g] u'8:6fl08Ë k|df0fkq lngsf nflu registrationdoctors.nmc.org.np
df uO tf]s]cg';f/sf] lja/0f / sfo{cg'ej clgjfo{ cWofjlws u/]sf] x'g'kg]{ 5 .
– k|df0fkq lngsf nflu cfj]bs :jo+n] lgj]bg lbg' kg]{5 . cfj]bs :jo+ pkl:yt x'gg;Sg] cj:yf ePdf
cflwsfl/s Od]n dfkm{t jf tf]s]sf] JolQmsf] ljj/0f / kl/ro v'Ng] k|df0f ;lxt l/tk'a{s d~h'/Lgfdf
lbPsf] JolQmn] cfj]bg ug{ ;Sg]5 .
– k|To]sk6s k|df0fkq k|fKt ug{sf nflu ;DalGwt lrlsT;sn] cfkm" kl5Nnf]k6s sfo{/t c:ktfn÷ lSnLlgs
jf cGo ;+ul7t ;+:Yffdf sfdsfh ul//x]sf] k|df0f k]z ug'{ kg]{5 . ;+:yfut ;]jfdf ;+nUgtf gePsf
cfj]bsn] ;f]lx Joxf]/f v'nfO{ cfj]bg lbg' kg]{5 .
– s'g k|of]hgsf] nflu k|df0fkq rflxPsf] xf] ;f] ;+:yfsf] gfd tyf sf/0f :ki6 sf/0f vf]nL lgodfg';f/sf]
b:t'/ a'emfO{ cfj]bg lbg' kg]{5 .
– g]kfn ;/sf/sf] ;]jfdf sfo{/t lrlsT;sx?sf] :t/ lgwf{/0f jf cGo k|of]hgsf nlfu dGqfno
jf ;/sf/L ;+:yfaf6 kqfrf/ eO{ cfPdf k|df0fkq lgMz'Ns k|bfg ul/g] 5 .
– cflwsfl/s lgosfoaf6 O{d]n jf kq dfkm{t btf{ ;DalGw hfgsf/L dfu eO{cfPdf lgMz'Ns k|dfl0ft
ul/g]5 .
– g]kfn ;/sf/ jf ;+ul7t ;+:yfn] k|bfg u/]sf] 5fqj[lQ jf sa'lnotdf cWoog u/]sf t/
tf]s]sf] ;]jfzt{ k"/f gu/]sf] JolQmnfO{ k|df0fkq k|bfg ul/g] 5}g . g]kfn ;/sf/ jf ;+ul7t ;+:yfn] k|bfg
u/]sf] 5fqj[lQ jf sa'lnotdf cWoog u/L tf]s]sf] ;]jfzt{ k"/f ug{ gkg]{ cfj]bsn] ;DalGwt dGqfno
jf ;+:yfaf6 :jLs[lt Nofpg' kg]{5 .
– kl5Nnf] k6s k|df0fkq lnPsf] tLg dlxgf leq ;f]lx k|of]hgsf nflu gofF k|df0fkq hfl/ ul/g]5}g .
– sfplG;nsf] sf/jfxLdf k/]sf] cfj]bsnfO{ k|df0fkq k|bfg ul/g]5}g .
******

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iiZ0805jWRPzLiqd011UxSqk9_Good standing form.pdf

  • 1. Nepal Medical Council Bansbari, Kathmandu Tel : +0977-01-4377164/4371954 Application for Registration Status (Certificate of Goodstanding) Name:_____________________________________________________________________ Date of birth : (AD) Year ______ Month ____ Day ___ (BS) Year ______ Month ____ Day ___ Sex : Male Female NMC registration No. : _________ Mobile No. _________________ Email address :_____________________________________________________________ Date of temporary registration (AD) Year ______ Month ____ Day ___ Date of permanent registration (AD) Year ______ Month ____ Day ___ Highest academic qualification: _____________________ Specialty ___________________ Current employer : __________________________________________ Since ___________ Reason for application : _______________________________________________________ Organization intended to submit registration status :________________________________ Undergraduate study scholarship or bond : Yes No If Yes, release letter. Postgraduate study scholarship or bond : Yes No If yes, release letter. Applicant's signature : __________________ Date : _______________ Checklist for application : 1) Duly filled application form 2) Photocopy of Temporary/Permanent/Specialist registration 3) Bank voucher/eBanking of Rs. 1,000 for Nepalese & Rs. 2,000 for Foreigner. Nepal SBI Bank Account Name Nepal Medical Council, A/C No. 2043 5240 1000 22 OR Rastriya Banijya Bank Account Name Nepal Medical Council, A/C No. 1150 1000 0233 1001 ;l6{lkms]6 ckm u'8:6fl08Ë k|df0fkq k|fKt ug{sf nflu cfjZos zt{x? – g]kfn d]l8sn sfplG;naf6 hf/Lx'g] u'8:6fl08Ë k|df0fkq lngsf nflu registrationdoctors.nmc.org.np df uO tf]s]cg';f/sf] lja/0f / sfo{cg'ej clgjfo{ cWofjlws u/]sf] x'g'kg]{ 5 . – k|df0fkq lngsf nflu cfj]bs :jo+n] lgj]bg lbg' kg]{5 . cfj]bs :jo+ pkl:yt x'gg;Sg] cj:yf ePdf cflwsfl/s Od]n dfkm{t jf tf]s]sf] JolQmsf] ljj/0f / kl/ro v'Ng] k|df0f ;lxt l/tk'a{s d~h'/Lgfdf lbPsf] JolQmn] cfj]bg ug{ ;Sg]5 . – k|To]sk6s k|df0fkq k|fKt ug{sf nflu ;DalGwt lrlsT;sn] cfkm" kl5Nnf]k6s sfo{/t c:ktfn÷ lSnLlgs jf cGo ;+ul7t ;+:Yffdf sfdsfh ul//x]sf] k|df0f k]z ug'{ kg]{5 . ;+:yfut ;]jfdf ;+nUgtf gePsf cfj]bsn] ;f]lx Joxf]/f v'nfO{ cfj]bg lbg' kg]{5 . – s'g k|of]hgsf] nflu k|df0fkq rflxPsf] xf] ;f] ;+:yfsf] gfd tyf sf/0f :ki6 sf/0f vf]nL lgodfg';f/sf] b:t'/ a'emfO{ cfj]bg lbg' kg]{5 . – g]kfn ;/sf/sf] ;]jfdf sfo{/t lrlsT;sx?sf] :t/ lgwf{/0f jf cGo k|of]hgsf nlfu dGqfno jf ;/sf/L ;+:yfaf6 kqfrf/ eO{ cfPdf k|df0fkq lgMz'Ns k|bfg ul/g] 5 . – cflwsfl/s lgosfoaf6 O{d]n jf kq dfkm{t btf{ ;DalGw hfgsf/L dfu eO{cfPdf lgMz'Ns k|dfl0ft ul/g]5 . – g]kfn ;/sf/ jf ;+ul7t ;+:yfn] k|bfg u/]sf] 5fqj[lQ jf sa'lnotdf cWoog u/]sf t/ tf]s]sf] ;]jfzt{ k"/f gu/]sf] JolQmnfO{ k|df0fkq k|bfg ul/g] 5}g . g]kfn ;/sf/ jf ;+ul7t ;+:yfn] k|bfg u/]sf] 5fqj[lQ jf sa'lnotdf cWoog u/L tf]s]sf] ;]jfzt{ k"/f ug{ gkg]{ cfj]bsn] ;DalGwt dGqfno jf ;+:yfaf6 :jLs[lt Nofpg' kg]{5 . – kl5Nnf] k6s k|df0fkq lnPsf] tLg dlxgf leq ;f]lx k|of]hgsf nflu gofF k|df0fkq hfl/ ul/g]5}g . – sfplG;nsf] sf/jfxLdf k/]sf] cfj]bsnfO{ k|df0fkq k|bfg ul/g]5}g . ******