Personal data
صحيح !
تم الإرسال بنجاح.
خطأ !
الرقم المدني مسجل من قبل
خطأ !
الرقم المدني غير صحيح
عذراً ... :
لا يمكنك التسجيل لأحد الأسباب التالية:
• الرقم المدني الذي تم إدخاله غير صحيح.
Name
(*)
Gender
(*)
Male
Female
Civil ID
(*)
Email
(*)
Nationality
(*)
- Select Nationality -
kuwait
United States
Egypt
Saudi Arabia
Iraq
United Arab Emirates
Lebanon
India
Jordan
Bahrain
Oman
Qatar
Tunisia
Morocco
Syria
Spain
France
England
Netherlands
Italy
Switzerland
Mexico
Argentina
Russia
China
Philippines
Yemen
Germany
Sweden
Portugal
Turkey
Greece
Belgium
Finland
Hungary
Ukraine
Austria
Australia
Romania
Denmark
Yugoslavia
Georgia
Algeria
Sudan
Somalia
Palestine
Libya
Mauritania
Iceland
Azerbaijan
Armenia
Central African Republic
Albania
Antigua &Barbuda
Andorra
Angola
Ethiopia
Iran
Eritrea
Europe
Estonia
Afghanistan
Ecuador
Pakistan
Brazil
Bahamas
Bosnia & Herzegovina
Turks & Caicos Islands
Montenegro
British Virgin Islands
Denmark
Cape Verde
El Salvador
Western Desert
Gabon
Cameroon
Congo
Democratic Congo
United Kingdom
Norway
Japan
Antarctica
Anguilla
Indonesia
Uruguay
Uzbekistan
Uganda
Ireland
Papua New Guinea
Paraguay
Palau
Barbados
Bermuda
Brunei
Bulgaria
Belize
Bangladesh
Panama
Benin
Bhutan
Botswana
Burkina Faso
Burundi
Poland
Bolivia
French Polynesia
Boyaca
Peru
Belarus
Thailand
Taiwan
Turkmenistan
Trinidad &Tobago
Chad
Cech
Chile
Tanzania
Togo
Tuvalu
Tonga
East Timor
Jamaica
Gibraltar
Grenada
Greenland
Netherlands Antilles
Comoros
Solomon Islands
Falkland Islands
Cayman Islands
Cook Islands
Marshall Islands
Mayotte
Christmas Island
Isle of Man
Dominican Republic
South Africa
Guadeloupe
Djibouti
Dominica
Rwanda
Reunion
Zambia
Zimbabwe
Cote d'Ivoire
Samoa
San Marino
Saint Vincent & the Grenadines
Saint Kitts & Nevis
Saint Lucia
Saint Helena
Sao Tome &Principe
Sri Lanka
Slovakia
Slovenia
Singapore
Senegal
Swaziland
Suriname
Sierra Leone
Seychelles
Serbia
Tajikistan
Gambia
Ghana
Guatemala
Guyana
Guiana
Guinea
Guinea-Bissau
Equatorial Guinea
Vanuatu
Venezuela
Vietnam
Fiji
Cyprus
Kyrgyzstan
Kazakhstan
New Caledonia
Croatia
Cambodia
Canada
Cuba
South Korea
North Korea
Costa Rica
Colombia
Kiribati
Kenya
Latvia
Laos
Lithuania
Luxembourg
Liberia
Liechtenstein
Lesotho
Martinique
Malta
Mali
Malaysia
Madagascar
Macedonia
Malawi
Maldives
Mongolia
Mauritius
Mozambique
Moldova
Monaco
Burma
Namibia
Nauru
Nepal
Niger
Nigeria
Nicaragua
New Zealand
Haiti
Honduras
Hungary
NULL
Mobile number
(*)
Copy of civil ID
(*)
Professional Data
Profession
(*)
Doctor
Dentist
Pharmacist
Nursing Staff
Technician
Job title
(*)
Assistant Registerer
Registerer
Senior General Practitioner
General practitioner
Specialist
Senior Specialist
Consultant
Approval of employer
(*)
Specialty
(*)
Years of Experience
(*)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
More Than 30 Year
Copy of Professional license
(*)
Place of residence
Governorate
(*)
- Select Governorate -
Al Asimah
Ahmadi
Farwaniya
Jahra
Hawalli
Mubarak Al-Kabeer
City
(*)
شروط الصورة الشخصية
• صيغة الصورة jpg, .png, .gif.
• أن تكون أبعاد الصورة 4*6 سم.
• ألا يزيد حجم الصورة عن 500 كيلوبايت.
• أن تكون الصورة واضحة، وحديثة.