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    MCIM Renewal Information of Registration No: I70874A

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    AtulSanap
    This document provides renewal information for MCIM Registration No. I70874A including personal details, contact details, qualification details, occupation details, and a confirmation statement. It lists the registrant's name, date of birth, father's name, spouse's name, addresses, mobile numbers, emails, educational qualifications including degrees in BAMS and MD Rasa Shastra evam Bhaishajya Kalpana, current occupation as a practitioner and teacher, and confirms the provided information is accurate.

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    MCIM Renewal Information of Registration No: I70874A

    Uploaded by

    AtulSanap
    2K views3 pages
    This document provides renewal information for MCIM Registration No. I70874A including personal details, contact details, qualification details, occupation details, and a confirmation statement. It lists the registrant's name, date of birth, father's name, spouse's name, addresses, mobile numbers, emails, educational qualifications including degrees in BAMS and MD Rasa Shastra evam Bhaishajya Kalpana, current occupation as a practitioner and teacher, and confirms the provided information is accurate.

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    Details_70874 (1)

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    This document provides renewal information for MCIM Registration No. I70874A including personal details, contact details, qualification details, occupation details, and a confirmation statement. It lists the registrant's name, date of birth, father's name, spouse's name, addresses, mobile numbers, emails, educational qualifications including degrees in BAMS and MD Rasa Shastra evam Bhaishajya Kalpana, current occupation as a practitioner and teacher, and confirms the provided information is accurate.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    2K views3 pages

    MCIM Renewal Information of Registration No: I70874A

    Uploaded by

    AtulSanap
    This document provides renewal information for MCIM Registration No. I70874A including personal details, contact details, qualification details, occupation details, and a confirmation statement. It lists the registrant's name, date of birth, father's name, spouse's name, addresses, mobile numbers, emails, educational qualifications including degrees in BAMS and MD Rasa Shastra evam Bhaishajya Kalpana, current occupation as a practitioner and teacher, and confirms the provided information is accurate.

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    MCIM Renewal Information of Registration No : I70874A

    Reference No : MTR_2168

    Registration No : 70874

    Date: 2019-04-06 13:45:21

    ;;

    Personal Details

    ATUL DNYANDEO
    Name Gender Male
    SANAP

    Date Of Birth 09-May-1986 Place of Birth HIWARSINGA

    DNYANDEO
    Father's Name Mother Name MANGAL
    KACHARU SANAP

    VARSHA ATUL
    Spouse's Name Blood Group A +ve
    SANAP

    PAN Card
    Aadhar Number 778316584210 EOLPS6513D
    Number

    Contact Details

    Alternate
    Mobile Number Link
    9403330067 Mobile Number 7721001869
    With Aadhar
    1

    Alternate Mobile Landline


    8788585238
    Number 2 Number

    Alternate Email
    Email Id [email protected] [email protected]
    Id

    Contact Address Details

    Address AT.HIWARSINGA TA. SHIRUR KA. DIST. BEED,

    Area City BEED

    Taluka Shirur District Beed

    State MAHARASHTRA Pincode 414205

    Qualification Details
    Page: 1
    Registration
    Registration Number 70874 Certificate 07431
    Serial No

    Date Of
    Schedule A 31-July-2012
    Registartion

    Qualification(Specified
    in Second,Third &
    Fourth Schedule to Year Of
    B.A.M.S. 2011
    the Indian Medicine Passing
    Central Council
    Act,1970)

    Year Of Degree
    2012 Faculty Ayurveda
    Awarded

    Maharashtra
    Name Of the Name Of the Government Ayurved
    University of Health
    University College/Institute College,Vazirabad,Nanded
    Sciences, Nashik

    Name Of SSC
    Passing year Of SSC 2002 Maharashtra State Board
    Board

    Name Of HSC
    Passing year Of HSC 2004 Maharashtra State Board
    Board

    New Additional Qualification Details

    State From
    Which
    Qualification M.D Additional MAHARASHTRA
    Degree/Diploma
    Obtained

    Loknete Rajarambapu
    Maharashtra Patil Ayurved Medical
    Name of the Name Of
    University of Health college, hospital,P.G.
    university Institute/College
    Sciences, Nashik institute and research
    centre, urun islampur

    Subject / Rasa Shastra evam Year Of


    2015
    Specialisation Bhaishajya Kalpana Passing

    Occupation Details

    Practitioner Details

    Practitioner
    Practitioner Address Practitioner Mode Practitioner Type
    System

    Page: 2
    MAULI CLINIC NEAR
    GRAMSEVAK
    Own Integrated Daily
    COLONY BALEPIR
    NAGER ROAD BEED

    Teacher Details

    Teacher
    CCIM Teacher Code AYURB1339 AYURVEDA
    Faculty

    RASA SHASTRA &


    Department BHAISAJYA State MAHARASHTRA
    KALPANA

    Maharashtra Dr. Vedprakash Patil


    Name Of the Name Of the
    University of Health Ayurved College &
    University College
    Sciences, Nashik Research Institue, Jalna

    Assistant Professor(
    Designation
    Lecturer )

    I, solemnly confirm that if any information provided by me is found false, I shall be held
    responsible in the matter. I shall have no objection if any action is taken by the MCIM against me.

    Date :

    Signature :

    Page: 3

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