Registration For Main Conference
Payment Details For Registration

LOCAL - LKR.4000

LIFE MEMBERS - One day LKR.2500

SAARC - 150 USD

FOREIGN - 200 USD

Email address *
Surname *
Your answer
Other Names *
Your answer
Designation *
NIC/Passport *
Your answer
Contact No *
Your answer
Country *
Your answer
Registration *
Registration No / License No *
Your answer
Current Hospital *
Your answer
Unit / Department *
Your answer
Experience ( Years , Months) *
Your answer
Meal Type *
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google.