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APPLICATION FORM

Fellowship in Cardio-Metabolic Medicine

CDEE & CC Con-2026
Kushabhau Thakre International Convention Centre, Bhopal

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Full Name *

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Place *

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Age on 01-01-2026 *

Current Designation *

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Academic & Professional Details

Highest Qualification & Year of Passing *

Clinical Experience (Years) *

No. of Publications *

Conferences attended last 10 Years *

Fellowship of Professional Bodies *

Important Notes

* The decision of the credential committee of Fellowship shall be final.
* Selected candidates will be required to pay Rs. 20,000/-.

Cardiology, Diabetology, ECG, Echo & Critical Care

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