Application for Renewal Of Registration   with the
Maharashtra Medical Council, Mumbai
Application No :  MMC20240001849 Date : 12/01/2024
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)  HILE PRAKASH NAMDEO
Registration No:  2009020154   Registration Date : 03/02/2009   Valid upto Date :03/02/2029
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. HILE PRAKASH NAMDEO
Name of Father : Mr.
Name of Mother : Mrs.
In Case of Married Women
Maiden Name : -

RESEDENTIAL ADDRESS : A-704, REGENCY PARADISE, GAURPADA ROAD, OPP. SHUBHAM COMPLEX, MILIND NAGAR, KALYAN WEST, KALYAN, THANE
City : KALYAN District : THANE
State : MAHARASHTRA Country : INDIA
Pincode : 421301
Date of birth : 27/09/1978 Tel No (Res) : Clinic No :
Mobile No : 8451802818 Email Id : prakash78hile@gmail.com  
Total Obtained Credits Points : 40
Remaining Credits Points : 0
Qualification Details
 Details of QualificationName of CollegeUniversityPassing YearCertificate NoCertificate Date
1.M.B.B.S.RGMC THANEMUMBAI UNIVERSITY2008  
Pariticulars Of Payment
Payment Mode : Online Payment
Receipt No : 0781891011
Receipt Date : 16/01/2024
   I have uploaded following documents:
1.Latest Passport size Photograph
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 : 12/01/2024
    Applicant signature               


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