Registration for ISPR 2023
Are you ISPR member:
Are you a consultant/resident(*)
*(Residents are requested to mail a bonafide certificate of residency to email@example.com signed by their Head of the Department)
State of Medical Registration (*)
Andhra PradeshArunachal PradeshAssamBiharChhattisgarhGoaGujaratHaryanaHimachal PradeshJharkhandKarnatakaKeralaMadhya PradeshMaharashtraManipurMeghalayaMizoramNagalandOdishaPunjabRajasthanSikkimTamil NaduTelanganaTripuraUttar PradeshUttarakhandWest BengalAndaman and NicobarChandigarhDadra and Nagar Haveli and Daman and DiuDelhiJammu and Kashmir*LakshadweepLadakh*Puducherry
Medical Registration No.(*)
Registration for workshop (select only one) (*)
(Select)Ultrasound Hip and Spine by Dr. Alka KarnikHRCT Chest: How I interpret diffuse and focal lung diseases in children by Dr. Ashu Seith BhallaCardiac MR and CT by Dr. Prakash MasandWorkshop by Royal college of Radiology, Uk on Neonatal ImagingNone
*Add Rs. 500 to the conference registration tariff if you are registering for workshop.
Will you need accommodation?(*)
* If double/triple occupancy rooms are desired, kindly make full payment for all the attendees together and send transactions details to the email id- firstname.lastname@example.org; or send a screenshot of transaction details over whatsapp to- 9130088522.
Amount paid for accommodation (If availing accommodation):
Total amount paid:
UTR no./Bank Reference no: