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. Mohan Gupta

2

Present Position/ Designation

:

Consultant Gen. Surgeon / President of Osmania Medical College Alumni Association.

3

Address

:

Aarogya Hospital, No. 5-4-183-199, Moazam Jahi Market, Hyderabad-01.

 

                                                                        

4

Phone No

:

98490-80430

5

Fax No

:

 -

6

E-Mail

:

drmohangupta@yahoo.com

7

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

:

Osmania Medical College, Hyderabad

8

Courses studied

:

M.B.B.S.

9

Year(s) of Study : From - To

:

1976-1982

10

Payment for membership is being made as  under

:

Life-Member 

11

Cheque / DD No

:

015249

12

Date

:

13/02/2017

13

Bank

:

Oriental Bank of Commerce

14

Amount (Rs)

:

Rs.500/-