1 / 1

Name --------------------------------------------------

REGISTRATION FORM 1 st Basic Surgical Skills Course Department of Surgery Jawaharlal Institute of Postgraduate Medical Education & Research 30 th March 2014 NTTC Hall, 4 th Floor, JIPMER Academic Centre, JIPMER. Name --------------------------------------------------

gisela
Télécharger la présentation

Name --------------------------------------------------

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. REGISTRATION FORM 1st Basic Surgical Skills Course Department of Surgery Jawaharlal Institute of Postgraduate Medical Education & Research 30th March 2014 NTTC Hall, 4th Floor, JIPMER Academic Centre, JIPMER Name -------------------------------------------------- Department -------------------------------------------------- Registration number -------------------------------------------------- Institute Affiliation -------------------------------------------------- Address -------------------------------------------------- -------------------------------------------------- -------------------------------------------------- Mobile number -------------------------------------------------- E-mail -------------------------------------------------- Course restricted to maximum of 24 participants Registration is free, but mandatory (Registration Includes Breakfast, Lunch, Refreshments and Course material) Please send the completed registration form to skillscoursejipmer@gmail.com Last date for receiving completed Registration form- 28.03.2014

More Related