The 4th Aceh Cardiovascular Update Registration Form
Fill out the form carefully for registration
Profession Type
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Please Select
General Practitioners
Specialists
Students
Nurses
Name
*
The name will be put in your certificate
Mobile Number
*
Please enter mobile number
Email ID
*
Enter email ID
Confirm Email ID
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Re-enter email ID
Select Your Package (General Practitioners)
*
IDR 250.000; Workshop
IDR 600.000; Symposiums
IDR 650.000; Workshop + Symposium
Select Your Package (Specialist)
*
IDR 400.000; Workshop 3
IDR 1.100.000; Workshop 4 (Post Cardiac Surgery: Essential Evaluation Using Echocardiography and Practical Approach to Lung Ultrasound in Emergency Setting: Differentiating Cardiac and Pulmonary Causes of Dyspnea)
IDR 700.000; Symposium
IDR 1.000.000; Symposium + Workshop 3
IDR 1.800.000; Symposium + Workshop 4 (Post Cardiac Surgery: Essential Evaluation Using Echocardiography and Practical Approach to Lung Ultrasound in Emergency Setting: Differentiating Cardiac and Pulmonary Causes of Dyspnea)
Select Your Package (Student and Nurse)
*
IDR 400.000; Symposium
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Select Your Workshop
*
Cardiopulmonary Exercise Test: How to Perform and Interpret
Select Your Workshop
Payment
Please transfer your payment by transfer to account number: Bank Syariah Indonesia (BSI) 8484848542 (PERKI Cab. Aceh). After completing the payment, please upload your transfer receipt below.
Please Upload Your Transfer Receipt
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