SUMMER SYMPOSIUM – 2023

On Integrated Approach to Airway Diseases
Venue: The Empress Hall, Fairfield by Marriott, Kolkata,
CB 218, CB Block B, Action Area 1C, Newtown, Kolkata - 7000156

Date: 28th May 2023
Name :

Age :

Sex :
MaleFemaleOthers
Phone Number :

Email :

Address :

City :

State :

Pin :

Country :

Institute / Hospital :

PGTNON-PGT

I hereby enclosed cheque / demand draft / Cash / money transfer through net banking
no. Date Drawn on in favour of “Institute of Pulmocare & Research”.

Signature :
Date :

Registration fees:

  Registration till 20th May 2023:  PGT: Rs. 1500/-  Non PGT: Rs. 2500/-

         Spot registration:  PGT: Rs. 2500/-  Non PGT: Rs. 3500/-

Bank Account Details of the Institute

Name of the Account: Institute of Pulmocare & Research
Bank Name & Branch: State Bank of India, CF Block, Salt Lake, Kolkata 700 064
Account Number: 31344713421
IFSC: SBIN0012360
PAN Card No: AAAAI0592E