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. Challa Chandra Shekhar
2	Present Position/ Designation	:	Civil Asst. Surgeon
3	Address	:	HIG-353, Phase-1, Madhava Nagar Colony, BHEL Township, R.C.Puram, Medak Dist.-502032.
4	Phone No	:	040-23023014
5	Fax No	:
6	E-Mail	:
7	Name of the College from where he / she has studied last	:	Osmania Medical College.
8	Courses studied	:	M.B.B.S.
9	Year(s) of Study : From - To	:	1978-1984
10	Payment for membership is being made as  under	:	Cheque
11	Cheque / DD No	:	022637
13	Date	:	09/11/2009
14	Bank	:	State Bank of Hyderabad.
15	Amount (Rs)	:	Rs. 500/-