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Form - 'H'
Application for Registration of Additional Qualifications
Name (As per registration certificate)
*
Apply Date
*
MM slash DD slash YYYY
Father’s/Husband’s Name
*
Full (Permanent) Residential Address
*
Mobile Number
*
Email ID
*
Aadhar Number
*
Registration of Additional Qualifications of
*
Obtained From
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Obtained Year
*
Registration Number
*
Date of Registration
*
DD slash MM slash YYYY
Documents need to be upload
(max size-1MB file types-pdf, jpg, docx)
Aadhar Card (mandatory)
*
Accepted file types: jpg, pdf, docx, Max. file size: 1 MB.
All year marksheet (B. Pharm / M. Pharm / Pharm. D)
*
Accepted file types: jpg, pdf, docx, Max. file size: 1 MB.
Photograph
*
Accepted file types: jpg, pdf, docx, Max. file size: 1 MB.
First Registration Certificate (both side)
*
Accepted file types: jpg, pdf, docx, Max. file size: 1 MB.
Fee Receipt (UPI/UTR/Transaction/Account No.)
*
Accepted file types: jpg, pdf, docx, Max. file size: 1 MB.
Provisional/Permanent Degree
*
Accepted file types: jpg, pdf, docx, Max. file size: 1 MB.
Specimen signature
*
Accepted file types: jpg, pdf, docx, Max. file size: 1 MB.
Affidavit
*
Accepted file types: jpg, pdf, docx, Max. file size: 1 MB.
One year training certificate (Pharm D applicant only)
Accepted file types: jpg, pdf, docx, Max. file size: 1 MB.
Note: At the time of verification of original documents in the council office, also submit the original copy of your provisional certificate, oath sheet and pharmacist registration certificate along with A4 size envelope and 9x4 size envelope with pasted speed post stamp (current charges) and 1 Passport size photo.
(नोट: काउन्सिल कार्यालय में मूल दस्तावेजों के सत्यापन के समय अपने प्रोविजनल प्रमाण पत्र, शपथ पत्र एवं फार्मासिस्ट पंजीकरण प्रमाण पत्र की मूल प्रति के साथ A4 साइज एवं 9x4 साइज के स्पीड पोस्ट (मूल्य के बराबर) टिकट लगे हुए लिफाफे व 1 पासपोर्ट साइज़ फोटो भी जमा करायें ।)
Note: Please take a prior appointment with the Council before visiting the office to submit all documents.
(नोट: काउन्सिल से अनुमति लेने के पश्चात् ही मूल दस्तावेजों के सत्यापन के लिए काउन्सिल में उपस्थित हों ।)
Additional Registration fee Rs 700 for BPharm and MPharm.
Pharm D Rs 1000.
For online payment -
Account Holder - Uttarakhand Pharmacy Council
Bank - State Bank of India
A/c No. - 36821630863
IFSC - SBIN007893
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I hereby confirm that the above information is correct. I undertake to provide the originals of any of the documents mentioned above should they be required by UKPC. I accept that UKPC Rules and Regulations stipulated here may be subject to change.
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