Application for Renewal Of Registration   with the
Maharashtra Medical Council, Mumbai
Application No :  MMC20240015863 Date : 02/04/2024
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)  BHADRA DEEP MAHENDRA
Registration No:  2014041393   Registration Date : 17/04/2014   Valid upto Date :17/04/2029
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. BHADRA DEEP MAHENDRA
Name of Father : Mr.
Name of Mother : Mrs.
In Case of Married Women
Maiden Name : -

RESEDENTIAL ADDRESS : 303, NALANDA, NEELKANTH KINGDOM, NATHANI ROAD, VIDYAVIHAR WEST, MUMBAI .
City : MUMBAI (SUBURBAN) District : MUMBAI (SUBURBAN)
State : MAHARASHTRA Country : INDIA
Pincode : 400086
Date of birth : 01/11/1990 Tel No (Res) : Clinic No :
Mobile No : 9022220914 Email Id : deepbhadra67@gmail.com  
Total Obtained Credits Points : 61
Remaining Credits Points : 0
Qualification Details
 Details of QualificationName of CollegeUniversityPassing YearCertificate NoCertificate Date
1.M.B.B.S.MGMMC, NAVI MUMBAIMGM INSTITUTE OF HEALTH SCIENCES (DEEMED UNIVERSITY), NAVI MUMBAI2014  
2.M.S.(Obst. & Gynae.)KJ SOMAIYYA MEDICAL COLLEGE & RESEARCH CENTRE, MUMBAIMAHARASHTRA UNIVERSITY OF HEALTH SCIENCES, NASHIK20180653/201901/03/2019
Pariticulars Of Payment
Payment Mode : Online Payment
Receipt No : 202409370902326
Receipt Date : 03/04/2024
   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 : 02/04/2024
    Applicant signature               


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