Training Registration Form – Health Training Center, Dhankuta

📋 Training Information

Training Name *

Role in Training *

Participant Trainer Co-Trainer Coordinator

Training Site *

Province

District

Starting Date *

Ending Date *

Fiscal Year *

👤 Personal Information

Name (in Block Letters) *

नेपालीमा नाम (Name in Nepali)

Sex *

Male Female Other

Date of Birth (BS) *

Format: 2050/05/15

Sex – Other (Specify)

🏠 Permanent Address

Province

District

Rural / Municipality *

Ward No. *

Contact No. *

Email

👥 Caste

If Other, Specify

🩺 Cadre

Medical Nursing Paramedics Other

If Other, Specify

Qualification *

💼 Sponsored By

Sponsor Type *

Sponsor Details (Name / Specify)

🏢 Working Place

Working Organization (Office) *

District

Province

Rural / Municipality *

Office Contact No.

Designation *

Level

PIS No.

Citizenship No. & Issued District

Council Reg. No.

By submitting this form, you confirm that the information provided is accurate. Your record will be reviewed by Health Office, Sankhuwasabha before being archived.

Form Submitted Successfully!

📋 Training Information

👤 Personal Information

🏠 Permanent Address

👥 Caste

🩺 Cadre

💼 Sponsored By

🏢 Working Place