YOUNG FRIENDS OF AL-SHIFA Trust
MEMBERSHIP
FORM
Name
_____________________________________________________
Sex
Male
Female
DOB ________________
Father’s Name
______________________________________________
Country
__________________________________
District
___________________________________
City
______________________________________
Contact # (Phone)
__________________________
Address
___________________________________________________
E-Mail
_____________________________________________________
Name Of School/College
______________________________________________
Address Of School/College
____________________________________________
____________________________________________________________________
Al-Shifa Trust Eye Hospital, Jhelum
Road, Rawalpindi, Pakistan. Tel.: 9251-5487820 Fax: 9251-5487827
Email: info@alshifa-eye.org.pk
Web: www.alshifa-eye.org.pk