DPH Training

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Name of the District *

Name of the Health Unit District (HUD) *

Name of the Institute* ADD

NOTE: "Please Contact Respective DPH Office" If Any Changes Need in the Institute Details Page

Institution Trust Name

Institution Address

Pin Code

Name of the Principal

Mobile Number of the Principal

Email of the Principal

Email Id (Email Id is your Default Username)

Mobile Number

First Name*

Last Name*

Password*

Confirm Password*

DECLARATION: "I hereby declare that the information given by me in this application is true and correct and no information has been suppressed to the best of my knowledge and belief. In case any information given by me is proved to be false or incorrect at any stage, I shall be responsible for the consequences, which may include among other things, cancellation of my application, be at any stage. I further declare that shall maintain good conduct, pay the requisite fee and other charges as applicable, and abide by the rules and regulations of the DPH&PM without fail."

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