INDIAN BOARD OF ALTERNATIVE MEDICINES
11TH International Congress,
Convocation & Award Presentation Ceremony
1st & 2nd January 2005, Hotel Hyatt Regency Calcutta

REGISTRATION FOR DELEGATES

Name:

Sex:

Nationality:

Qualification/Titles:

Street:

City:

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Country

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Fax:

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Payment Details:-Bank Name:

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Dated:

I wish to read a paper on:

I wish to attend the training workshop:

In case of student, please type in your Roll No. and the course name,so that your certificate can be kept ready to be presented during the convocation.