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UTTAR PRADESH DENTAL COUNCIL

5, Sarvapalli, Mall Avenue Road, Lucknow

(Issued under section 32(2) / 35(4) of the Dentists Act, 1948)

UTTAR PRADESH DENTIST'S REGISTRATON CERTIFICATE

Certificate No :

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Roll No :

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This is to certify that the person named below has been registered as a DENTIST in the Uttar Pradesh under the provision of Dentists' Act,1948

Registration in Part

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Name

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Mother's Name Smt.

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Father's Name Sri.

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Qualification

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Year of Passing

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College

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University

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Date & Place of registration

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Address

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This certificate shall remain inforce upto :-

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Underwent rotatory Internship Training from

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Place

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Lucknow

U.P. Dental Council has the right to cancel the certificate, if any information is found to be incorrect or fake.

Born

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Fee receipt No.

:

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