ICMR Centenary Celebrations & XXIX Annual Conference of Indian Society for Medical Statistics

Registration Form

 

XXIX Annual Conference of Indian Society forMedical Statistics

Name :
Prof/Dr/Mr/Ms.

Age :

Sex : Male / Female

Designation :

Membership Status: Yes / No
If Yes, Membership No.
 
Abstract submitted : Yes / No

Organization

 

Address

 

Mobile: Phone(Off):

Email ID :

Wish to participate : Workshop - Yes / No

Conference - Yes / No

Registration Fees to be paid by Demand Draft in favor of “ISMSConference 2011” payable at Chennai.

 DD No: Bank:                                                       Amount: Rs.

Workshop participants should provide the following information:
PG(Subject)
 
Specialization

Signature of Applicant

Date

 

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