mrcog 2 & 3 - bsog - registation.pdf · payment details amount drawn on bank cheque / dd number...
TRANSCRIPT
Payment Details
Amount
Drawn on Bank
Cheque / DD Number
REGISTRATION FORM
Name
Phone Number
City
Qualifications
Hospital / Institute
Designation / Course
Mode of Payment (Cheque / DD)
MRCOG 2 & 3Intensive Revision Course
Course Fees
` 15,000/-Online Paymenthttp://feepal.org/Online-Payment/coaching/Iirrh
th Tuesday, 13 June 20178.30 AM - 6.00 PM
Day 1 th Wednesday, 14 June 2017
8.00 AM - 6.00 PM
Day 2
International Institute for Training andResearch in Reproductive HealthInternational Institute for Training andResearch in Reproductive HealthInternational Institute for Training andResearch in Reproductive HealthInternational Institute for Training andResearch in Reproductive HealthInternational Institute for Training andResearch in Reproductive Health
Payment by Cheque / DD can be made in favour of "IIRRH" and forwarded tothe address below.
IIRRH - No.7, East Park Road, Kumara Park East, Bangalore - 560 001.
Mob: +91 78291 92444 Email: [email protected] Web: www.iirrh.org