Registration Form
Spotlight on
Primary Immune Deficiency Disorders

Sunday, August 18th 2019
Kabani Hall,
Institute of Maternal and Child Health (IMCH)
Government Medical College, Kozhikode, Kerala

Registration fee Till Aug 10th After Aug 10th and spot
IAP member 750/- 1000/-
Non IAP member 1250/- 1500/-
PG student 500/- 750/-

Online Transfer Details:
Indian Overseas Bank, Chevayoor branch
A/c Name: FPID (USA) Regional Diagnostic Centre for Primary Immunodeficiency Diseases
A/c No.089901000014519
IFSC Code: IOBA0000899

Please keep a copy of the Bank Transfer Acknowledgement Slip
Keep the details of the Bank Transaction with you before you proceed further
You will Require
1) Transaction ID
2) Transaction Date
3) Transaction Amount
4) Bank Name
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