Issue Intership Certificate Intership Certificate Processing 1Login2Select Candidate3Candate Details4Program Details5Approver Details6Review & Submit Certificate Serial NumberYour Email Password* Enrollment ID*This field is hidden when viewing the formValidation Candidate DetailsThis field is hidden when viewing the formIntership ID*Full Name*Date Of Birth* DD slash MM slash YYYY EID Number*Graduation Title*Name Of University*Nationality*Email* Program DetailsProgram Type*Institution Name*Please SelectCanadian Specialist Hospital Dubai.Aster Hospitals Dubai.fdgdfgdfgdfgProgram Director Name*Please Select– Fill Out Other Fields –Program Director Designation*NIHS Accreditted*Accredittation Number*This field is hidden when viewing the formProgram Director Sign*Enrollment Start Date*Enrollment End Date*This field is hidden when viewing the formEnrollment Start Date* DD slash MM slash YYYY This field is hidden when viewing the formEnrollment End Date* DD slash MM slash YYYY Rotation Interruption Occcured?* Yes No Interruption Start Date* DD slash MM slash YYYY Interruption End Date* DD slash MM slash YYYY Reason for Interruption*Rotation details : Medical*RotationDuration Please SelectInternal MedicineFamily MedicinePediatricsPsychiatryGastroenterologyPulmonologyDermatologyRadiologyIntensive Care Unit (ICU)Clinical PathologyThalassemiaNeurologyNuclear MedicineGeneral SurgeryEmergency MedicineOrthopedicsObstetrics and GynecologyOphthalmologyPlastic SurgeryUrologyOrthopedicsNeurosurgeryAnesthesiaENTPediatric SurgeryPlease Select4 Weeks5 Weeks8 Weeks9 Weeks Add RemoveTotal Duration: 0 Weeks This field is hidden when viewing the formRotation LogicRotation details : Dental*RotationDuration Add Remove Approver DetailsApprover Name*Please SelectDr. Khawla AlhajajdffdgfdgDesignation*Organization*Approver Email* This field is hidden when viewing the formeSignature* {custom_fields} NameThis field is for validation purposes and should be left unchanged.
