* Request Informations :




Full Name :  *
First name Second Name Third Name Family Name
 
National Number :  *  
 
Work Place :  *  
 
Resident Place :  *  
 
  Contact Informations :
Phone Number :  *    
Email :  *    
Post Address :
 
A copy of the personal ID/passport :  *

Institution, University, Department Name :  *  
 
Document Description/Required Information :

 *  
 
The purpose of obtaining information :           *
 
Document Format :         *
 

  • I am obligated to use the information for the purpose for which it was obtained, and to indicate the source of the information I obtained, according to the scientific and legal principles in force.
  • The request shall be answered or rejected within thirty days from the second day of the date of submitting the request
  • Refusal to respond within the specified period shall be considered as a rejection decision

 *
JCIA
ISO 9001
HCAC
ISO 22000
BABY FRIENDLY HOSPITAL / HCAC