Registration Form
Video Endo Gynae Workshop & Hands-on Training
29th April, 2017
Department of Obstetrics & Gynaecology, Maulana Azad Medical College
Under Aegis of DGES
Venue: MAMC Auditorium
Surgical Skills Lab, B.L. Taneja Block, MAMC.
Your answer
Email ID
Your answer
Your answer
Your answer
Address (correspondence)
Your answer
Telephone/Mobile No.
Your answer
Payment Mode
In case of DD or Cheque, Demand Draft No./ Cheque No. (to be drawn in favour of Endo Gynae Conference-2017, payable at Syndicate Bank, MAMC, New Delhi) :
Your answer
Bank Name
Your answer
In Case of Direct Money Transfer, refer the following:
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms