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PATHWEL

PATHWEL Center of Hematology

& Bone Marrow Transplant

A project of Pakistan Thalassaemia Welfare Society

Appendix-D

Reference Form

Details of at least two people, other than relatives, who have knowledge of the candidate's work experience and/or education.

Name of Candidate:Muhammad Niaz KhanPosition:________________

Reference 1

Name: ________________	Designation: ________________
Company Name: ________________	Address: ________________
Telephone (Home): ________________	Telephone (Office): ________________
Mobile: ________________	Email: ________________
Fax: ________________	Other: ________________

Reference 2

Name: ________________	Designation: ________________
Company Name: ________________	Address: ________________
Telephone (Home): ________________	Telephone (Office): ________________
Mobile: ________________	Email: ________________
Fax: ________________	Other: ________________