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REGISTRATION FORM
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REGISTRATION FEES
Category
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Consultant
Resident
Pathologist & Radiologist Consultant
Pathologist & Radiologist Resident
First Name
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Last Name
*
Your answer
Gender
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Male
Female
Designation
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Institution / Hospital
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City
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State
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Mobile
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E-mail
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Wish to add Accompanying Person(s) ? *
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1
2
3
Accompanying Person(s) Detail (Name, Age, Gender)
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Kindly submit your Registration Fees as per category and choice. After successful transaction, please share successful payment receipt through E-MAIL id :
bmorthooncocon@gmail.com
OR WHATSAPP at +918619944728
SCAN & PAY REGISTRATION FEES
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