Full Name:
(which You Would Like To Appear On Certificate)
Gender: Age:Institute:Designation:
Member (ICS / NCCP):Membership No.:NonMemberPGCorporateForeign
State:Medical Council No.:
Phone: STD/ISD Code:Mobile:
E mail:Diet:VegNon VegJain

Name:Age:VegNon VegJain
Age:VegNon VegJain


Title of Workshop



*All rates inclusive of 18% GST. Subject to change as applicable at time of registration.
For outstation cheque add Rs.100. For payment by card, 2.5% card fee will be charged additional.


- 80% of the paid amount would be refunded if registration is cancelled before 31st March 2018.

- 50% of the amount would be funded if registration is cancelled before 30th September 2018.

- No refund will be awarded after 30th September 2018 even after cancellation.


1.Registration for participating in the conference is mandatory for all delegates, Registration is non-transferable.

2.Photo ID is mandatory for event entry, for all delegates owing to security reasons.

3.Please ensure that you wear the registration badge in the event premises.

4.Delegates must bring the receipt at the time of registration.

5.We will send you the confirmation letter of registration along with your Registration ID, 30 days after receiving payment.

6.PG Students need to submit letter from Dean / HOD for participating in the conference.

7.Please mention your registration number in all transactions.

8.All Remittance / Bank Charges / Online transaction fees need to be paid by the delegate.

9.The Delegate Kit would be handed over only to Registered Delegates. As an exception, the kit would be handed over to representatives authorized by the Registered Delegate with a copy of their signed Authority Letter. For SPOT Registration DELEGATE KIT will be subject to Availability.

10.Entry of the accompanying person may be restricted to certain areas at the Venue as decided by the organizing committee.

11.The organizing committee will not be responsible for loss or theft of personal belongings.