29th State Conference
On Sunday, 9th June 2019
At The Windsor Castle Hotel
Kottayam

Brochure - Registration Form

*District:		Select Districts Thiruvananthapuram Kollam Pathanamthitta Alappuzha Kottayam Idukki Ernakulam Thrissur Palakkad Malappuram Kozhikode Wyanad Kannur Kasargod
*Name:
*Designation:		Select Director Deputy Director District Medical Officer Superintendent Technical Assistant Chief Medical Officer Medical Officer Resident Medical Officer
Email:
Land Phone:
*Cell Phone :
*Regn. Fee Paid To:		Select District Treasurer District Secratary District President
*Accommodation Required:		Yes No
		A/C Non A/C Select Budget Below Rs.1000 Rs.1000 – Rs.2000 Above Rs.2000 No. of Adults: No. of Children (less than 5yrs):
No. of Vegetarians:
No. of Non-Vegetarians:
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