Physican Assistants Forms.pdf - Medical & Dental Council Ghana

FOR OFFICE USE ONLY
Received By:__________________________________________________________
Checked By:__________________________________________________________
Date ____/____/_____
Day M Year
Date ____/____/_____
Day M Year
Amount Paid:_________________________________________________________ Receipt No.:__________
Signature of Officer:____________________________________________________
Date ____/____/_____
Day M Year
Registrar’s Comments:_______________________________________________________________________
__________________________________________________________________________________________
Signature:____________________________________________________________
Date ____/____/_____
Day M Year
Chairman’s Approval:________________________________________________________________________
__________________________________________________________________________________________
Signature:____________________________________________________________
Date ____/____/____
Day M Year
Approved: Yes No Date ____/____/____ Registration No.:_____________________
Day M Year
Entered Into Database By: _______________________________________________
Date ____/____/____
Day M Year
5