Application for Renewal Of Registration   with the
Maharashtra Medical Council, Mumbai
Application No :  MMC202135227 Date : 09/07/2021
To,
Registrar ,
Maharashtra Medical Council ,
189/A, Anand Complex, 2nd Floor,
Sane Guruji Marg, Arthur Road Naka,
Chinchpokali (W), Mumbai - 400 011.
 
Sub: Dr  (Smt/Shri)  NAHATKAR TANAY SACHIN
Registration No:  2016083480   Registration Date : 31/08/2016   Valid upto Date :31/08/2026
Sir,
I the undersigned applicant, request yoy that my name may be continued on the Register of Medical Practitioners maintained by the Maharashtra Medical Council as per 23 (a)/23 (c) of MMC Act 1965 and amendment 2003. My particulars are as Follows :
Name of Applicant : Mr. NAHATKAR TANAY SACHIN
Name of Father : Mr. NAHATKAR SACHIN MANOHAR
Name of Mother : Mrs. NAHATKAR CHARULATA SACHIN
In Case of Married Women
Maiden Name : -

RESEDENTIAL ADDRESS : SHARDA MARKET, GANESH WARD, PANDHURNA,
City : CHHINDWARA District : CHHINDWARA
State : MADHYA PRADESH Country : INDIA
Pincode : 400012
Date of birth : 25/10/1991 Tel No (Res) : 9653427191 Clinic No : 9049551675
Mobile No : 9049551675 Email Id : nahatkar@gmail.com  
Total Obtained Credits Points : 50
Remaining Credits Points : 0
Qualification Details
 Details of QualificationName of CollegeUniversityPassing YearCertificate NoCertificate Date
1.M.B.B.S.BJMC PUNEMAHARASHTRA UNIVERSITY OF HEALTH SCIENCES, NASHIK2016  
2.M.S.(Ortho.)GSMC MUMBAIMAHARASHTRA UNIVERSITY OF HEALTH SCIENCES, NASHIK20201416/202105/04/2021
Pariticulars Of Payment
Payment Mode : Online Payment
Receipt No : IGALMHPUI1
Receipt Date : 12/07/2021
   I have uploaded following documents:
1.Latest Passport size Photograph
2.Photocopy Of Additional Qualification certificate of MMC
3.Self attested photocopy of MMC Registration Certificate
4.Self attested photocopy of Aadhar Card
DECLARATION (Registered Medical Practitioner)
I shall abide by the Code of medical Ethics as enunciated in the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002.
Date : 09/07/2021
    Applicant signature               


NOTE:- You do not need to submit the print out of original submitted Renewal Application form to MMC office.