Full Name

Mobile Number(start with 254..)

Email

Passport Size Photo

Staff Category -- Select Category -- Staff Intern Attachee

Institution

Department -- Select Department -- ICT Laboratory Pharmacy Imaging & Diagnostics Hospitality Warehouse PCC Physiotherapy Social Work Central Records Dental Physiotherapy Admin TSSU Training School Training & Research Biomedical Public Health Stores Telephone Exchange Accounts Nutrition Corporate Laundry Occupational Therapy Orthopaedic ENT PSC Consultant Clinic A&E GBVRC Hospice Oncology Human Capital Director Nursing Quality Assurance IPC APDK EYE Clinic MORGUE KWEE Funeral MATT WELLNESS OBAMA BLOOD BANK MARTENITY DIFFCOV LABOUR WARD WARD 1 WARD 2 WARD 4 TRAUMA WARD WARD 7A WARD 7B WARD 8 WARD 9 VVMC Victoria Renal ICU Theatre HDU

Start Date

End Date

HMIS Reg Number(Funsoft)

Reference Code(Worth KES 3000)

Payment Receipt (Upload receipt for KES 3000) Accepted formats: JPG, PNG, PDF