KAPICON 2023

Name as to appear on the certificate :

Mobile Number :

Email :

Date of Birth :

Gender :

Hospital / Institution name :

Postal Address :

Department :

Designation :

API Membership No :

Food Preference :

State Medical Council Reg No :

Medical Council :

Category :

Accompanying Person :

Accompanying Person Name :

Amount :

1. Registration & Accommodation booking is closed - Please register on Spot

2. Conference Kit for Spot Registrations subjected to availability.

3. Certificates without Credit Hours will be issued to Spot Registrations.

INR