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CONGRESUL ANUAL AL ASOCIA Ţ IEI MEDICALE ROMÂNE 10 – 12 APRILIE 201 4 FORMULAR INSCRIERE

CONGRESUL ANUAL AL ASOCIA Ţ IEI MEDICALE ROMÂNE 10 – 12 APRILIE 201 4 FORMULAR INSCRIERE. NUME: ____________________________________________________________ PRENUME: _____________________________________________________________

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CONGRESUL ANUAL AL ASOCIA Ţ IEI MEDICALE ROMÂNE 10 – 12 APRILIE 201 4 FORMULAR INSCRIERE

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  1. CONGRESUL ANUAL AL ASOCIAŢIEI MEDICALE ROMÂNE 10 – 12 APRILIE 2014 FORMULAR INSCRIERE NUME: ____________________________________________________________ PRENUME: _____________________________________________________________ SPECIALITATEA: medic primar / specialist / rezident / student SPITALUL: _____________________________________________________________ ADRESA: ______________________________________________________________ TELEFON: _____________________________________________________________ FAX: ______________________________________________________________ E-MAIL: ______________________________________________________________ TAXÃ PARTICIPARE Pana pe 30 martie Dupa 30 martie / pe loc Medici specialişti: 50 RON 100 RON Rezidenţi: 30 RON 50 RON Studenţi: GRATUIT GRATUIT Taxa de participare se va achita în contul Asociaţiei Medicale Române, fie prin ordin de platã (Cod fiscal: 8345234; Cont bancar: RO25RNCB0082001042050001, Banca BCR - UNIRII), fie direct la sediul Asociaţiei Medicale Române, Str. Ionel Perlea nr. 10, Sector 1, Bucureşti. Nu se acceptã plata prin mandat poştal. Studenţii vor fi admişi pe baza carnetului de student cu viza actualizatã. Formularul de înscriere şi copia dovezii plãţii taxei de participare vor fi trimise cãtre urmãtoarele coordonate:tel. 021.211.15.08 int.135; fax 021.312.13.57, e-mail: amr.secgen@gmail.com, cassimona@yahoo.com sau poştã: ASOCIAŢIA MEDICALĂ ROMÂNĂ, Str. Ionel Perlea, nr. 10, sector 1, Bucureşti. Informaţii suplimentare despre congres puteţi gãsi pe site-ul: www.amrorg.ro, www.paginamedicala.ro

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