Information Proforma

 
 
     
 
     
 
 
Name : __________________________________
 
Institute : __________________________________
 
Address : __________________________________

__________________________________
 
E-mail : __________________________________
 
Tel :

__________________________________

 
Attending : Alone  /  With Spouse
 
Departure on : __________________________________
  by ____________________________________
 
Return Reservation required : Yes / No
 
Accommodation Required : Yes / No 
Single / Double
Veg / Non-Veg
 
     
 

An Invitation

Inv. to Doctors

 Tent. Prog.

Spon.Rates

Org. Committee

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Guest Faculty