{"id":8905,"date":"2025-05-19T08:55:22","date_gmt":"2025-05-19T05:25:22","guid":{"rendered":"https:\/\/iranafra.com\/physician-registration-form\/"},"modified":"2025-12-27T16:30:32","modified_gmt":"2025-12-27T13:00:32","slug":"physician-registration-form","status":"publish","type":"page","link":"https:\/\/iranafra.com\/en\/physician-registration-form\/","title":{"rendered":"Physician registration form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"8905\" class=\"elementor elementor-8905 elementor-4640\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e4aa31d e-flex e-con-boxed e-con e-parent\" data-id=\"e4aa31d\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-f1d5745 e-con-full e-flex e-con e-child\" data-id=\"f1d5745\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6ce2afe elementor-widget elementor-widget-heading\" data-id=\"6ce2afe\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Doctor registration form<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dbfebd8 elementor-button-align-end elementor-widget elementor-widget-form\" data-id=\"dbfebd8\" data-element_type=\"widget\" data-settings=\"{&quot;button_width&quot;:&quot;20&quot;,&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" id=\"physicianregistrationform\" name=\"Physician registration form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"8905\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"dbfebd8\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"\" \/>\n\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"full name\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-family elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[family]\" id=\"form-field-family\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Medical license number\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-nationalcode elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[nationalcode]\" id=\"form-field-nationalcode\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\" Medical specialty\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-fathersname elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[fathersname]\" id=\"form-field-fathersname\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Practical experience\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Email\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-Education elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[Education]\" id=\"form-field-Education\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Education level\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-phonenumber elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[phonenumber]\" id=\"form-field-phonenumber\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Contact number\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-age elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[age]\" id=\"form-field-age\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\" Full address\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-message elementor-col-100\">\n\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[message]\" id=\"form-field-message\" rows=\"4\" placeholder=\"Additional comments or your message to us \"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-fileupload elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-fileupload\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPlease upload your ID card:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[fileupload][]\" id=\"form-field-fileupload\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" multiple=\"multiple\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-20 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm elementor-animation-grow\" type=\"submit\" id=\"send\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">sends<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Doctor registration form<\/p>\n","protected":false},"author":15,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-8905","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/iranafra.com\/en\/wp-json\/wp\/v2\/pages\/8905","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/iranafra.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/iranafra.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/iranafra.com\/en\/wp-json\/wp\/v2\/users\/15"}],"replies":[{"embeddable":true,"href":"https:\/\/iranafra.com\/en\/wp-json\/wp\/v2\/comments?post=8905"}],"version-history":[{"count":1,"href":"https:\/\/iranafra.com\/en\/wp-json\/wp\/v2\/pages\/8905\/revisions"}],"predecessor-version":[{"id":8906,"href":"https:\/\/iranafra.com\/en\/wp-json\/wp\/v2\/pages\/8905\/revisions\/8906"}],"wp:attachment":[{"href":"https:\/\/iranafra.com\/en\/wp-json\/wp\/v2\/media?parent=8905"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}