Section 144 in The Maharashtra Medical Practitioners (Registration) Rules, 1961
144.
, Mahatma Gandhi Road, Fort, Bombay 400 001.Dear Sir,I hereby request that my name and other particulars as mentioned below may be entered in the Register under sub-section (3) of section 17 of the Maharashtra Medical Practitioners' Act, 1961 -(1)Full name of the applicant (in block capitals beginning with surname).(2)Maiden name and surname if the applicant is a married woman (in block capitals beginning with surname)(3)Nationality(4)Residential address (in block capitals)(5)Date and place of birth (in words and figures)(6)(a)Qualification which entitles the applicant to registration(b)Date on which the applicant obtained the qualification.(c)Authority which conferred or granted the qualification.(d)Details of the institutions where the applicant received training and details of the training and periods thereof
