ONLINE NOMINATION FORM "" 1 NOMINATION FORM (Kindly tick only ONE sub- category and Attach additional sheets / informationwherever required)Nomination is on-going and closes on May 25th 2018. NameFull Name of Nominatorno-icon Telephone Number:no-icon Emaila valid emailemail AWARD CATEGORIES (Kindly tick only ONE sub- category and Attach additional sheets / informationwherever required) A. SPECIAL AWARDSLifetime Achievement Award. Outstanding CSR Health Project of the year.Healthcare Media Excellence Award-Print.Healthcare Media Excellence Award-Electronic.Healthcare Friendly Financial Institution of the year. OR B. HEALTHCARE DELIVERY SERVICESPrivate Healthcare Provider of the year.Private Laboratory Service Provider of the yearRadiology Service Provider of the year.Health Maintenance Organization of the year.PharmAccess Innovative Healthcare Service Provider of the yearPhysiotherapy Service Provider of the yearIVF Service Provider of the YearDialysis Service Provider of the year.Eye Care Service Provider of the year.Dental Service Provider of the year.Nursing and midwifery Excellence AwardsTertiary Healthcare Provider of the year.Healthcare Information Technology Provider of the year. OR C. BIOMEDICAL TECHNOLOGYBiomedical Engineering Service Company of the YearLaboratory Equipment Marketing Company of the YearHospital Equipment Marketing Company of the year OR D.PHARMACEUTICALSPharmaceutical Retail Outlet of the YearPharmaceutical Manufacturing Company of the year. DETAILS OR NOMINEE Full Name(Individual or Organization)no-icon Designationno-icon Postal Addressno-icon Telephoneno-icon Mobileno-icon Emailsemail Websiteno-icon REASON(S) FOR NOMINATION: Please describe your experience, uniqueness / novelty of the facility or service provider and the reasons for your nominations 0 / Submit Form Previous Next FormCraft - WordPress form builder
