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Account Details

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Profile Details

First name (required)

What is your personal name?

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Middle name

Have a second name? What is it?

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Last name (required)

What is your surname?

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Sex (required)

A male or female?

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Mobile Number (required)

A cell phone number that is reachable

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Occupation (required)

So who are you in term of what you do?

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Pharmacist registration number

What is your unique ID in the Pharmacy council?

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Organization

Where are you working?

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Job Title

So you are working as . . .

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Profession

Which field are you in?

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