Registration


Name*
Age
Sex
Qualification
Years of Experience
Address
Official Address
City
State
Pin Code
Institute/Organization
Mobile*
Email*

The registration fee is Rs. 1500 for Trainees and Rs. 2000 for Practitioners.

A Cheque/DD should be payable in favour of “FORTIS MALAR HOSPITALS LTD, HDFC BANK LIMITED, THIRUVANMIYUR, CHENNAI”.Account No: 08478480000017

The registration form along with the cheque / DD should reach the following address on or before 18th March 2015.

Fortis Malar Hospital,
No 52, 1st Main Road,
Gandhi Nagar, Adyar,
Chennai – 600020

For any registration enquiries, call Ms Ramya / Nandhini – +91 8939831218 / 8939831212 or mail us at malar.conference@fortishealthcare.com

Note: Request you to share the details on successful payment to malar.conference@fortishealthcare.com