WORKSHOP REGISTRATION FORM (IHEX 2018)
1st International Islamic Healthcare Conference and Expo (2018)
April 10th - 12 th 2018
Jakarta Convention Center, Jakarta, Indonesia
ESTABLISH SHARIAH HOSPITAL IN THE REGION THROUGH CONSOLIDATION OF POTENTIALS OF THE UMMAH
Full Name *
e.g. Prof. Dr. dr. Syarifuddin Wahid, Ph.D., Sp.PA(K)., Sp.F
Your answer
Institution *
Your answer
Address *
e.g. Jl. Cempaka Putih Tengah VII No. 12, Central Jakarta, DKI Jakarta Province (Indonesia)
Your answer
Telephone Number with WhatsApp Application *
e.g. + 62 813 8081 7939. If you do not have WhatsApp application, please indicate with the minus sign (-)
Your answer
Valid email *
Your answer
Workshop Options *
TERM OF PAYMENT
Registration Fee can be done throgh Bank Transfer:
BNI Syariah (Swift Code: SYNIIDJA)

BNI Syariah Account (Bank Code 009)
760221222-0
Atas nama: Majelis Upaya Kesehatan Islam Seluruh Indonesia

Information on Free Paper Session
Log in and submit for abstract are as follows:

www.mukisi.com/abstract

Scientific Committee can be reached through email: ihex2018@gmail.com

DOWNLOAD IHEX 2018 GUIDELINE BOOK
You can Download, through this link:
bit.ly/GuidelineIHEX_Indonesian (Indonesian Version)
bit.ly/GuidelineIHEX_English (English Version)
FURTHER INFORMATION ABOUT 1st IHEX 2018
Seminar and Workshop:
Ade (+62 812 87129149)
Sekretariat (+62 813 8081 7939)
Email: mukisipusat@yahoo.co.id

Booth and Expo:
Munawir (+62 856 9796 8585)
Email : munawir.sitiaisyah@gmail.com

Murta Wijaya (+62 812 9044 3438)
Email : murtawijaya19@gmail.com

Thank You for your Participation. We look forward to welcome you to IHEX 2018
Establish Shariah Hospital in The Region!
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