Registration Information

❖ Personal Details

Name in English

Title * :

First name * :

Last name * :

Department * :

Institution * :

❖ Contact Details

Address * :

City/District:

State/Province * :

Postal code * :

Country * :

Telephone No. * :

Mobile phone no.:

E-mail * :

❖ Food details

Food details * :

❖ Registration Type

Type	Fee Onsite rate (USD)
Main Congress
Physicians	400.00
Residents/ Nurse/Medical Staffs/ PT	300.00
Accompanying Person* reference presenter name:	100.00
Dinner
Gala Dinner	35.00

Total 0.00 USD

Registration rates are subject to change based on the time of payment. To qualify for the Early-Bird or Regular rates, payment must be finalized within the designated timeframe. Any payments made after a period deadline will be adjusted.

Remark: * The verification document from the organization or university is required

Coupon:

(If any)

The verification document from the organization or university is required (Student): (*.jpg, *jpeg, *.png , *.pdf)

❖ Receipt Details

same as contact address

Name * :

Address * :

Tax ID:

Please fill the required fields(*).