(Required for all intending participants including those who have registered for the Main Congress.) |
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Name of delegate: |
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Identity Card number: (for doctors as in MMC-CME registration) |
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Current Post: |
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Contact Address: |
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Tel No: |
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Fax No: |
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Fees to be paid (please circle and write the relevant amount)
Please make payment by cheque, bank draft,
or money order payable to 'Perinatal Society Congress' and send to
the Congress Secretariat. |