Registration for CSEP 2017
JUNE 28th - July 1st 2017
DEPARTMENT OF GENERAL SURGERY
ST.JOHNS MEDICAL COLLEGE AND HOSPITAL
Email address
Full Name
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Address
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Mobile/Contact number (Include Area Code)
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Current Institution
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Medical Council Registration No. (State)
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Name of the State Medical Council
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Date of Medical Council Registration
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Please check your Registration number as it is required for CME points. No changes will be allowed later.
EARLY BIRD EXTENDED UP TO MAY 31st. REGISTRATION Rs2500/- TILL MAY 31
Prices for rooms
Single occupancy Rs 780/day
Double occupancy Rs 545/day (Per-Person)
Registering for
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Single occupancy
Double occupancy
Accomodation
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Workshop (First come First Serve basis)
FOOD
Veg
Non-Veg
Food
Mode Of Payment
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By Demand Draft In Favor of "St Johns Medical College Hospital" Payable at Bangalore
Enter the DD number/NEFT or IMPS Transaction ID Below
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Enter Date Below
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Enter the Bank Branch Below
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For any queries ontact
Dr. Ann Sunny / Dr Vivekanandan
7829870367

Or Email :- csep2017@gmail.com

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