Application form for Six months training course for 18th Batch.

GOVERNMENT OF GOA STATE FAMILY WELFARE BUREAU DIRECTORATE OF HEALTH SERVICES CAMPAL, PANAJI- 403 001 APPLICA TION F OR S IX MONT HS CE RT IFICA TE TRAINING COURSE IN T HE FUNDAME NT ALS OF ABD OM INO –PELVIC ULT RA S ONOGRAPH Y LEVEL ONE FOR MBBS DOCT ORS 1. Full name of the doctor : ______________________________________________________ 2. Date of Birth (DD/MM/YYYY): _____/____/_____________ 3. G (Extractive summary — verify with official source.)