ORIGINAL – DEFERMENT REQUEST FORM 10 December 202211 December 2022 PGMCDU, FMF ORIGINAL - DEFERMENT REQUEST FORM Student Name in Full*Registration No.*Email* Program*Batch*Duration of Deferment*Reason for Deferment*MedicalOfficialPersonalNote: Written Evidence to be furnishedBrief Explanation*Supporting Documents Drop files here or Date* Approval (For office use only)EvidenceAttachedNot AttachedStatusAcceptedRejectedCoordinatorHigher Degree Committee Date and Approval