Online registration

Venue:

Rustom Choksi Auditorium,Golden Jubilee Building,Tata Memorial Hospital,Parel,Mumbai

Conference Dates:

19/06/2026 to 21/06/2026

Title *

First Name *

Middle Name

Last Name *

Date of Birth

Department

Badge/Certificate Name * (This will be appear on certificate)

Email *

Mobile *

Organisation

Medical Council Reg. No.*

Postal Address

Postal Code

City*

Country*

Passport Number

Normal Registration

Category	Early Bird Fees	Upto Date	From Date	Fees
Conference 19-20 June PG Students	5000.00	30/05/2026	31/05/2026	6000.00
Conference 19-20 June Delegates	6000.00	30/05/2026	31/05/2026	7000.00
CME 19.06.2026	1800.00	30/05/2026	31/05/2026	2000.00
Faculty	3000.00	30/05/2026	31/05/2026	3000.00

Conference 19-20 June PG Students	9000.00
Conference 19-20 June Delegates	10000.00

Select	Date	Description	Upto Date - Fees	After Date - Fees
	28/02/2026	Dinner on 20 th June 2026 (For Delegate)	30/05/2026 - 500.00	31/05/2026 - 500.00

Total Cost :

Mode of Payment *

Demand Draft

Cheque

Payment Gateway

DD No.

Bank Name

Verification Code

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