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First Name
Last Name
Gender
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Female
Email
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Practice name
Country
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Afghanistan
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American Samoa
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Antarctica
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China
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Congo, the Democratic Republic of the
Cook Islands
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Dominican Republic
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Equatorial Guinea
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French Southern Territories
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Georgia
Germany
Ghana
Gibraltar
Greece
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Grenada
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Guatemala
Guinea
Guinea-Bissau
Guyana
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Heard Island and Mcdonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
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Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
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Macedonia, the Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova, Republic of
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
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Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
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Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Province of China
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.s.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Street address
State/Region
Postcode
Practice software
Cliniko
Core Practice
Coreplus
Nookal
Praktika
Practice speciality
If you are a multi-disciplinary practice, please select the majority discipline.
General Practice
Physiotheraphy
Special Health Service
Hospital
Other Allied Health
Dentist
Consultant/Service Provider
Primary Health Network
Association/Governing Body
Psychologist
Radiologist
Occupational Therapist
Psychiatrist
Podiatry
Optometrist
Chiropractor
Chinese Medicine Practitioner
Osteopath
Pathologist
Pharmacy
Vaccination Centre/Respiratory Clinic
Dietitian
Nutritionist
SLMC
The SLMC number is the personal unique registration number with the Sri Lanka Medical Council.
The SLMC Registration Number must be numeric.
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