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Note : Please make sure that the first, middle and last name filled in the registration are the same as you would like to be displayed on your eCertificate of Participation (eCoP).

* fields are mandatory

Account and Personal Details

First Name *

Middle Name

Last Name *

Mobile Number *

Email *

Note: Continue by filling up below remaining details and complete registration by clicking on the "Register" option at the bottom.

Create Password *

Confirm Password *

Address

Current Affiliations *

Gender * Male Female Non-Binary

Address Type *
Personal Official

Address *

Country *

State *

City *

Zip Code

Registration Choices

State Medical Council Registration No.

Registration Category * Resident & Fellows Delegates International Delegates Trade Delegates SAARC Delegates

Select Workshop

Workshop

Batch 1 [9 am to 11 am] (INR 500)

Batch 2 [11 am to 01 pm] (INR 500)

Slide to add Accompanying Persons (if any) and enter their details

Children under the age of 5years are welcome guests

I certify that the information submitted in this application is true and correct to the best of my knowledge.

I further understand that any false statements may result in denial or revocation of the certificate.

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Account and Personal Details

Address

Registration Choices

Select Workshop

Workshop

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