Registration Form

Delegate Details*

Name*

Designation*

Name on Badge*

Email*

Mobile*

Address*

City*

State*

Country*

Pincode

Category* Please choose any one of the following category

Accompanying Person * You could accompany maximum 2 members.

Pre Conference Symposium * You could choose for Pre-Conference Symposium on Water & Electrolyte Balance & ABG Analysis

Accomodation Required * You could choose for accomodation . Payment will have to be made at the time of conference in College Campus

Category	Early Bird(upto 15^thApril, 2017	From 16^th April, 2017- Upto 30^thSeptember, 2017	From 1^stOctober, 2017 onwards & Spot
UPAPI Member	Rs. 2000	Rs. 3000	Rs. 5000
Non-UPAPI Member	Rs. 2500	Rs. 3500	Rs. 5000
Accompanying Person (per Person)	Rs. 2000	Rs. 3000	Rs. 5000
PG Student	Rs. 1500	Rs. 1500	Rs. 2000
Industry Professional	Rs. 3000	Rs. 5000	Rs. 7000