APPLICATION FORM FOR RENEWAL

 

 

From:                                                                    To:

                                                                             The Registrar,

                                                                             A.P.Nurses and Midwives Council,

                                                                             Sultan Bazar, Hyderabad– 500 095

 

Sir,

 

          Sub: Renewal of Registration as Nurse / Midwife / Public Health Nurse

                / Health Visitor / Auxiliary Nurse – Midwife / Health Worker –

                regarding.

 

***

 

          I have registered my name as Nurse / Midwife / Public Health Nurse                / Health Visitor / Auxiliary Nurse – Midwife / Health Worker bearing the following Registration numbers with Andhra Nurses and Midwives Council / Hyderabad Nurses, Midwives & Health Visitors Council / Andhra Pradesh Nurses, Midwives, Auxiliary Nurse – Midwives and Health Visitors Council.

 

          Registration Number:                                Date of Registration

 

          Nurse………………………………………….                   ………………………………….

 

          Midwife……………………………………….                   ………………………………….

 

          Public Health Nurse…………………..                     ………………………………….

 

          Health Visitor……………………………..                   ………………………………….

 

          Auxiliary Nurse Midwife……………..                   ………………………………….

 

          Health worker…………………………….                   ………………………………….

 

 

          I am herewith enclosing a Demand Draft No. …………………………………….dated…………….……for Rs………………………………..( Rupees in words) ………………………………………………………………………………………………………………………..….

Towards renewal of fee as Nurse / Midwife / B.Sc., (Nurse) / Public Health Nurse / Health Visitor / Auxiliary Nurse – Midwife / Health Worker in favour of “ANDHRA PRADESH NURSES & MIDWIVES COUNCIL, HYDERABAD” from any nationalized bank payable at Hyderabad.

 

(Name of the Bank………………………………………………………..D.D.No………………………)

 

          A self addressed envelope with Rs………………….Postage Stamps affixed is enclosed for sending the receipt of the Renewal Fee by Regd. Post.

 

 

          Thanking you,                                                        Yours faithfully,

 

 

 

                                                                             (Signature of the Applicant)

N.B. :- Delete whichever is not applicable,

if you have renewed previously please send

the renewal receipt.

 

Renewed on…………………………………………………

 

Remain in force ………………………………………….

 

 

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