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National Centre for Disease Informatics and Research
National Cancer Registry Programme
(Indian Council of Medical Research)

Registration for all Oncology Software Module
Registration Form to be Completed by oncologist / Medical College / Cancer Hospital / Clinic / Lab with interested in use of  Oncology Software
1. Name of the Institution
Postal Address Phone Number
Fax Number
Emaild ID
2. Name of Head of Institution Mobile Number
3. Name and Designation of
Principal Investigator
Co-Principal Investigator
Faculty in Charge
4. Brief Profile of the Institution
 
Year 2014 2015 2016
Number of In-Patient Beds
Total Out-Patient attendence
Total Registration
Total Proved Malignancies
5. Number of Specimens/Biopsies/Smears (Non-Malignant & Malignant) reported during the year 2016 at department of Pathology
Total
(Malignant & Non - Malignant)
Malignant
Histopathology Specimens / Biopsies
Cytology Smears including FNAC
Haematology Smear (including Peripheral Smear / Bone Marrow)
Total
6.  Number of patients treated during the year 2016 at Departments of
Seen / Diagnosed Treated
Medical Oncology
Radiation Oncology (RT)
Surgical Oncology
7.   Remarks