Nomination Form

+91 8130776213

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Noida, Delhi NCR, INDIA

Nomination Form

Fill the Nomination Form

For Which Award Form To Be Filled

Want to

Nomination type

Nominee Name

Name of Organization

Name of Organization Head

Organization Head Designation

Organization Head Mobile Number

Organization Head Email ID

Name of contact person

Designation of contact person

Mobile Number of contact person

Complete adrress

Official website (if any)

Year of inception

GST no. (if any)

Annual turnover

Nomination level for

Previous awards (if any)

Executive Name

Remarks

Terms & Conditions By filling and submitting the nomination form, I declare that I have read and understood the Application, Selection process and the Terms & Conditions of the International Healthcare Achievement Awards, 2025. I hereby agree and accept the same. I further declare that information provided in the nomination form is true to the best of my knowledge and belief.

H-225/213, sector - 63, Noida, Delhi NCR, 201301

https://www.devoxilmedia.com/

📞 +91 8130776213

Nomination Form

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