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Online Subscription Form for Ex-Pharm

This document is an online subscription form from the Health Education Bureau dated July 26, 2021. It contains details about Mr. Suraj Kumar Patil, an assistant professor, who is subscribing to the 3-year full pack of the Experimental Pharmacology (Ex-Pharm) Series Software for 29547.2 rupees. The form provides contact information for the Health Education Bureau and includes fields for the subscriber's name, address, pin code, email, mobile number, subscription year, product details, duration, price, and payment options.

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Suraj Patil
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132 views2 pages

Online Subscription Form for Ex-Pharm

This document is an online subscription form from the Health Education Bureau dated July 26, 2021. It contains details about Mr. Suraj Kumar Patil, an assistant professor, who is subscribing to the 3-year full pack of the Experimental Pharmacology (Ex-Pharm) Series Software for 29547.2 rupees. The form provides contact information for the Health Education Bureau and includes fields for the subscriber's name, address, pin code, email, mobile number, subscription year, product details, duration, price, and payment options.

Uploaded by

Suraj Patil
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

7/26/2021 Online Subscription Form

Health Education Bureau


Addres: Health Education Bureau, 55/20, Rajat Path,
Mansarovar, Jaipur, Rajasthan, Pin: 302020

Contact: 0141-2783681, 07976447983, 09636348191


Mail: [email protected], [email protected]

Online Subscription Form

I/WE WANT TO SUBSCRIBE BELOW MENTIONED


PRODUCT, PLEASE ACCEPT MY/OUR SUBSCRIPTION
APPLICATION WITH FOLLOWING PARTICULARS

Date:26/07/2021 Ref. No:HEB/OFS/2021/22866

Name of
Mr.Suraj Kumar Patil{assistant professsor}
Individual/Institute/Organization

A/p-School of Pharmaceutical Sciences,Kolhapur,Sanjay


Address Ghodawat university,kolhapur Atigre,Dist-Kolhapur,Pin
416118

Pin Code 416118

E-Mail [email protected]

Mobile Number 8275183506

Subscription Year 2021

https://heb-nic.in/form/form.php# 1/2
7/26/2021 Online Subscription Form

Product Duration Price

Experimental Pharmacology (Ex-Pharm) Series Software 3 Years (Full Pack) 29547.2 ₹

29547.2
Total:
₹

Payment Options:

Cheque/Demand Draft
NEFT/RTGS
Pay Online

https://heb-nic.in/form/form.php# 2/2

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