ALUMNI ASSOCIATION OF OSMANIA UNIVERSITY
Office of the Registrar, Osmania University, Hyderabad-500 007
(Regd.No.590 0f 2003)
MEMBERSHIP FORM
Alumni Information:
1
Name in Full: Prof. / Dr. / Mr./Mrs.
:
Dr. Surya Mahender
2
Present Position/ Designation
Consultant
3
Address
H.No.1-2-381, Gagan Mahal Road, Hyderabad.
4
Phone No
9848028831
5
Fax No
6
E-Mail
7
Name of the College from where he / she has studied last
Gandhi Medical College.
8
Courses studied
M.B.B.S.
9
Year(s) of Study : From - To
1973-1979
10
Payment for membership is being made as under
Cheque
11
Cheque / DD No
271371
13
Date
09/11/2009
14
Bank
SBI
15
Amount (Rs)
Rs. 500/-