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Registration Form for PAFMATCON

Please Fill the Form Carefully and only press submit button once.

If you had already registered at PAFMATCON2012 Last Year, Then CLICK HERE.

This information will be used for making "PAFMATCON" certificates

If you want to send collective delegate list. Download this excel sheet and mail it to anil9637@yahoo.com after filling.

 

 

Profession: (Please Select any):       

Medical, Dental, Ayush, Nursing, Lawyers, Others,

 

Delegate Name:    

Mandatory Any Secret Code :      Like Password (Xy#123)
Fill any 6 digits and remember them for correction in your regist. details. if required in future.

Designation:     

Department

College

*Medical Council Reg. No. :   State 

(* Mandatory. Wrong Reg. No. will attract zero CME credit hours)

Correspondence Address

City State: Country:

Delegate's Mobile

Delegate's Email:

Registration Fee Paid:     500/- , 800/-, 400/- (Submit PG Certificate from HOD), Guest

Mode of Payment (Please Mention Transaction Number) :

Kindly send the Scanned Copy of Receipt if payment done in Bank Directly for confirmation of registration on Conference official E Mail address: singhvp@ gmail.com, Bank Details:

Account name "Dayanand Medical College & Hospital, Managing Society. Account Number 51202011017402 of Oriental Bank of Commerce (IFSC : ORBC0105120)

Check your details in pending registration database before submitting again. click here

Confirmed delegates. Please Click here

Rectify your details click here

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