Person with Disabilities
Percentage of Disabilities (%)
Language Skills
Registration with Indian/State Medical Council

I hereby state that I am not suffering from any medical condition either acute or chronic which can affect my training in KIMSHEALTH in an adverse manner. I have not been treated / treated for any chronic illness in the past (specify if indicated).

If any criminal offense or pending case against you.
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Accademic Referee (One Only)
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