Registration

Name

POA membership No:

Designation 

PMDC #:

Hospital

Postal Address

City

Mobile Number

Email



ACCOMMODATION INFORMATION

NIC # / Passport #

Accompanying person

Spouse + Children

Hotel:



Please declare name of accompanied person for registration

1.

2.

3.


Attention:

  1. The organizing committee shall be pleased to register all post retirement age POA Members on complementary basis (on request)
  2. Submit complete and proper accommodation information as above
  3. No complementary accommodation

 

Please post your registration form along with Cheque / Demand Draft / Proof of payment at Conference Secretariat address:

Registration Fee before 30st September, 2017 

No

Category

Registration fees

1

POA members       

 Rs 15,000

2

Non-POA member (Consultant)

 Rs 20,000

3

PGs (A letter of PG ship from concerned HOD will be required)

 Rs 6,000

4

Accompanying Person, Spouse, Children over 12(without bag)

Rs 5,000

5

Pharma Delegates (without bag)

Rs 5,000

 


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