#MeDeVision2019: Registration Form
All India Medical & Dental Students Conference

Venue : Geetanjali Medical College & Hospital, Udaipur, Rajasthan
Date : 3, 4 August, 2019
Reporting Time : 6 pm on 2nd August, 2019 to 8 am on 3rd August, 2019
Registration Fee : For Undergraduates - ₹ 500 /-
For Post-graduates - ₹ 750 /-
(Inclusive of Food, Accommodation & Local Transport)

Note : Food and Sharing/Dormitory type accommodation will be provided to delegates (except residents of Udaipur) from evening of 2nd August to evening of 4th August, 2019. If someone requires extra accommodation facility for night of 4th August as well, then they should specifically mention so while filling this Online Registration Form and communicate with us. Such requests will be considered at our discretion based on availability.

For Communication of #MeDeVision2019
Dr. Chintan - 9638075627
Dr. Kurush - 8689923959
Dr. Akash - 8058224979
Dr. Akshay - 9071802845
Dr. Virendra - 9425352313

FB: www.facebook.com/MeDeVisionOrg
Twitter: www.twitter.com/MeDeVisionOrg

Conference Secretariat :
MeDeVision, No. 55, Yuva Shakti, 1st Main Road, Sheshadripuram, Bangalore, Karnataka - 560020
Phone: +91 9100664444 | E: office.medevision@gmail.com | W: www.medevision.org

Please provide details for registration. All fields are mandatory.

Email address *
First Name *
Your answer
Last Name *
Your answer
Age *
Your answer
Sex *
Occupation *
Qualification *
Name of College/Institution *
Eg - ABC Medical College, Mumbai
Your answer
Mobile Number *
Please enter your 10 digit mobile number
Your answer
Address *
Your answer
City *
Your answer
State *
Emergency Contact *
Please enter mobile number of parent/guardian/emergency contact
Your answer
Whether Participating in Poster Presentation *
Whether Participating in Paper Presentation *
Whether I Need Accommodation Facility *
Suggestions for MeDeVision Resolution
Please give your valuable suggestion in brief to the Government, for Effective Medical & Dental Education. Genuine answers will be included in MeDeVision Resolution
Your answer
Whether I need accommodation for the night of 4th August ? *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service