Are you a paediatrician and member of Paediatrics Association of Nigeria (PAN) ? If yes, kindly fill the form below to submit your profile.

 

Registration Form

Title:
Surname:
First Name:
Other Names:
Gender:	Male Female
Fellowship Obtained:	WACP FMCP Others
Year of Fellowship:
PAN Registration
Have you been inducted? :	Yes No
Year of Induction:
Work Info
Work Area:	Public Hospital Private Hospital Company Hospital Nigerian Government Agency International Agency e.g. WHO, UNICEF etc NGO Others
What Level of facility are you working if in a health setting?:
	Primary Secondary Tertiary
Health Institution(s):
Location of Institution	(Where you work)
Full Address:
City:
LGA:
State:
Resident Country: Select s Afghanistan Albania Algeria American samoa Andorra Angola Anguilla Antarctica Antigua and barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and herzegovina Botswana Bouvet island Brazil British indian ocean territory Brunei darussalam Bulgaria Burkina faso Burundi Cambodia Cameroon Canada Cape verde Cayman islands Central african republic Chad Chile China Christmas island Cocos (keeling) islands Colombia Comoros Congo Congo, the democratic republic of the Cook islands Costa rica Cote d ivoire Croatia Cuba Cyprus Czech republic Denmark Djibouti Dominica Dominican republic East timor Ecuador Egypt El salvador Equatorial guinea Eritrea Estonia Ethiopia Falkland islands (malvinas) Faroe islands Fiji Finland France French guiana French polynesia French southern territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-bissau Guyana Haiti 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 Kazakstan Kenya Kiribati Korea democratic peoples republic of Korea republic of Kuwait Kyrgyzstan Lao peoples democratic republic Latvia Lebanon Lesotho Liberia Libyan arab jamahiriya Liechtenstein Lithuania Luxembourg Macau 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 Niger Nigeria Niue Norfolk island Northern mariana islands Norway Oman Pakistan Palau 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 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 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 Yugoslavia Zambia Zimbabwe
Practicing Subunit/ Area of Interest:
PAN Office Participation Details
Ever held office in PAN? :	Yes No
PAN office post held (1):
Tenure From:	Month Select January February March April May June July August September October November December Year Select 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921
To:	Month Select January February March April May June July August September October November December Year Select 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921
PAN office post held (2):
Tenure From:	Month Select January February March April May June July August September October November December Year Select 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921
To:	Month Select January February March April May June July August September October November December Year Select 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921
PAN office post held (3):
Tenure From:	Month Select January February March April May June July August September October November December Year Select 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921
To:	Month Select January February March April May June July August September October November December Year Select 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921
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