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.A.Gopal Kishen

2

Present Position/ Designation

:

Consultant Nephrologist.

3

Address

:

H.No.8-2-293/82, A657, Road No.33, Jublee Hills, Hyderabad-33.

4

Phone No

:

9866063899 / 040-23545567

5

Fax No

:

 

6

E-Mail

:

Gk_adikey@yahoo.com

7

Name of the College from where he / she has studied last

:

Osmania Medical College.

8

Courses studied

:

M.B.B.S., M.D.

9

Year(s) of Study : From - To

:

1953-1969

10

Payment for membership is being made as  under

:

Cheque

11

Cheque / DD No

:

050532

13

Date

:

20-09-2007

14

Bank

:

Andhra Bank.

15

Amount (Rs)

:

Rs 10,000/-