REGISTRATION FORM

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REGISTRATION FORM

October 31, 2026

Prefix

Full Name *

Mobile Number (WhatsApp Preferred) *

Email ID *

Profession *

Doctor

Admistrators \ Operations

Nursing

Pharmacist

Biomedical

Technician (OT/ ER/ ICU/ CSSD/ LAB/ OTHERS)

Billing/ Insurance/ Providers Support Executive)

Ward Seceretary

Other:

Name of Hospital / Institution *

Designation *

City *

State *

Meal Preference *

Vegetarian

Non-Vegetarian

Required

Please confirm the accuracy of the information provided and indicate your consent to receive CME updates via email or WhatsApp.

I hereby confirm that the information provided above is true and correct.

I consent to receive CME-related updates via email / WhatsApp.

PAYMENT *

Bank Transfer

UPI

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