5th Annual Conference of Cardio-Diabetic Society Registration form 2024

5th Annual Conference of Cardio-Diabetic Society, 2024
On behalf of the Organizing Committee, I would like to invite and welcome to the Hybrid Conference, which will take place on November 8th-9th, 2024 at AIIMS Rishikesh. It is our great pleasure to host this event.
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Membership ID
Full Name*

PrefixFirst NameMiddle NameLast NameSuffix
Name of Organization*
Designation
Email*
example@example.com
Mobile Number*

Area CodeMobile Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Payment Details:
FreeNot applicable
Rs. 2000 (01 September 2024 to 30 September 2024)Rs. 4000 (01 October 2024 to 31 October 2024)Rs. 6000 (01 November 2024 to 07 November 2024)Rs. 8000 (On spot)Not applicable
Rs. 1000 (01 September 2024 to 30 September 2024)Rs. 2000 (01 October 2024 to 31 October 2024)Rs. 3000 (01 November 2024 to 07 November 2024Rs. 4000 (On spot)Not applicable
Rs. 500 (01 September 2024 to 30 September 2024)Rs. 1000 (01 October 2024 to 31 October 2024)Rs. 1500 (01 November 2024 to 07 November 2024)Rs. 2000 (On spot)Not applicable
Payment Account Details with QR Code:

Name: Cardio-Diabetic Society
Account Number: 6189000100057023
Bank: Punjab National Bank
Branch: Barrage Const Div., Pashulok, Rishikesh
NEFT IFSC Code: PUNB0618900
Transaction details*

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