Issue Intership Certificate Intership Certificate Processing 1Access2Select Candidate3Review Candate Details4Add rotation details5Select Approver6Review & Submit Certificate Serial NumberYour Email Password*Coordinator name* 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*Candidate Email* Program DetailsProgram Type*Institution Name*Please SelectAmerican Hospital DubaiSaudi German Hospital DubaiMarina Dental Clinic DubaiLiberty Dental Clinic DubaiAACSH DubaiDento-Faces Cosmetic Clinic DubaiPrime Hospital DubaiProgram 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. Latifa AlrustamaniDr. Khawla AlhajajDesignation*Organization*Approver Email* This field is hidden when viewing the formeSignature* {custom_fields} NameThis field is for validation purposes and should be left unchanged.
