KERACON 2025

Form
Payment History

Name as to appear on the certificate :

Mobile Number :

Email :

Date of Birth :

Gender :

Department :

Designation :

Hospital / Institution name :

Postal Address :

City :

State :

Country :

Have you registered for the conference :

Conference registration Number :

Conference registration is mandatory. Kindly complete the registration process and then return to this link for only accommodation / CSI Course booking: Registration Link:https://formbuilder.ccavenue.com/live/ccavenue/keracon-2025

CSI Course :

Course :

Accommodation :

Hotel :

Rooms :

Twin Sharing Preferred With :

Mobile Number :

Nights :

Total Amount :

I accept below Terms & Conditions

INR