Bangladesh College of Physicians & Surgeons(BCPS)

Professional Development Department (IT Wing)

3-Day Training Program on Information and
Communications Technology(ICT)

Personal Information ( Step-I )
Year of Passing FCPS-1
Session
BMDC Registration No:
eg: A 72041
PEN/REG NO
eg: P-09-33-012171 / A-2016-1-48-0068
Name:
Subject:
Protocol SL No:
Mobile:
eg: Only 11 Digits number
E-mail:
Address
Bank Information
Bank Name:
Branch Name:
Deposit Date:
eg : YYYY-MM-DD
Scroll No:
Amount:
I hereby declare that if any information provided in the above mentioned Registration Form found wrong or incorrect, I will accept any disciplinary action taken against me by the college authority.
Uplode Image(Step-II) Note:After Complete Step-I than Click Upload Image
Upload Image(Step-II)