CKC - Workshop for Diabetologists: Online Registration Form

October 11, 2008
Chennai
Tamil Nadu

REGISTRATION FORM

Name:
Age:
Gender:	Male Female
Email:
Address:
PIN code:
Telephone:	(std code) -
Mobile:
Meal Preference:	Vegetarian Non-vegetarian
I will be sending the DD or Cheque for the total amount to the conference secretariat in the next three working days.