(h.q. department of physiology, b. j. medical college ... · state, at an elevation of roughly...

Dates

Time

Place

Last Date of Registration : 31st August, 2018

Last Date for Submission of Abstracts of

Scientific Papers, Posters and Lectures : 15 October, 2018

Dates

Time

Place

Last Date of Registration

Last Date for Submission of Abstracts of

Scientific Papers, Posters and Lectures

: 31st August, 2018

: 15 October, 2018

: 22-23 December 2018

: 9:00 am to 5:00 pm.

: Premnagar Ashram, Haridwar, Uttarakhand.

: 22-23 December 2018

: 9:00 am to 5:00 pm.

: Premnagar Ashram, Haridwar, Uttarakhand.

Registration Fees :

SOCIETY OF BASIC AND APPLIED PHYSIOLOGY IS ORGANIZINGSOCIETY OF BASIC AND APPLIED PHYSIOLOGY IS ORGANIZING

4 INTERNATIONAL CONFERENCE ONBASIC AND APPLIED PHYSIOLOGY-2018


(H.Q. Department of Physiology, B. J. Medical College, Ahmedabad)(H.Q. Department of Physiology, B. J. Medical College, Ahmedabad)

ICON BAP-2018 at Haridwar, UttarakhandICON BAP-2018 at Haridwar, Uttarakhand

Faculty

Students

Faculty

Students

Association Guest(Spouse & Family Member)

Faculty

Students

Faculty

Students

Association Guest(Spouse & Family Member)

: 2500 INR till 31st July, 2018


: 3000 INR till 31st August, 2018


: Same as Faculty





: Same as Faculty

Children Below 12 years

Children Above 12 years

Foreign & NRI Delegates

Children Below 12 years

Children Above 12 years

Foreign & NRI Delegates

: Free

: Same as Faculty

: Same as Faculty

: Free

: Same as Faculty

: Same as Faculty

(Delegate fees will be accepted only from Indian Bank account). No foreign contribution will be accepted.

NO SPOT REGISTRATIONS.

(Delegate fees will be accepted only from Indian Bank account). No foreign contribution will be accepted.

NO SPOT REGISTRATIONS.

THTH

Breaking News : Declaration of 5 National Awards for Excellence in PhysiologyBreaking News : Declaration of 5 National Awards for Excellence in Physiology

Bank Details :Bank Details :

Account Name

Account No.

Bank Name

IFS Code

Account Name

Account No.

Bank Name

IFS Code

: INTERNATIONAL CONFERENCE ON BASIC AND APPLIED PHYSIOLOGY

: 912010041533674

: AXIS BANK, CIVIL HOSPITAL BRANCH,ASARWA, AHMEDABAD

: UTIB0000449


: 912010041533674


: UTIB0000449

Sponsorship / Stall Booking :Sponsorship / Stall Booking :

One stall in exhibition for 2 days : 30,000 INR per Stall with complimentary

Lunch & Dinner for Staff

One stall in exhibition for 2 days : 30,000 INR per Stall with complimentary

Lunch & Dinner for Staff

Chair Person

Dr. J.M. Jadeja (Prof. & H.O.D Physiology.)

Chair Person

Dr. J.M. Jadeja (Prof. & H.O.D Physiology.)

Organizing Secretaries

Dr. Neeta Mehta, Dr. Anju Mehta

Organizing Secretaries

Dr. Neeta Mehta, Dr. Anju Mehta

Treasurer

Dr. Geeta Nair

Treasurer

Dr. Geeta Nair

Assistant Treasurer

Dr. Nilay Patel

Assistant Treasurer

Dr. Nilay Patel

Joint Organizing Secretaries

Dr. Saurin Sanghavi - Mo. 98257 68604

Dr. Paresh Prajapati - Mo. 99247 97300

Joint Organizing Secretaries

Dr. Saurin Sanghavi - Mo. 98257 68604

Dr. Paresh Prajapati - Mo. 99247 97300

Organizing Committee

Faculty & Residents of Physiology Department, B. J. Medical College, Ahmedabad.

(Host Department)

Organizing Committee

Faculty & Residents of Physiology Department, B. J. Medical College, Ahmedabad.

(Host Department)

Scientific Committee :Scientific Committee : Convenor

Co-Convenor

Members :

Convenor

Co-Convenor

Members :

Dr. Neeta Mehta

Dr. Anju Mehta

Dr. Amitabh Dubey (Jaipur)

Dr. Jasmin Diwan (Gandhiangar)

Dr. Geeta Nair

Dr. Neeta Mehta

Dr. Anju Mehta

Dr. Amitabh Dubey (Jaipur)

Dr. Jasmin Diwan (Gandhiangar)

Dr. Geeta Nair

Registration Committee :Registration Committee : Convenor

Co-Convenor

Members :

Convenor

Co-Convenor

Members :

Dr. Rachit Joshi

Dr. Vijay Goplani

Dr. K. V. Raval, Dr. Toral Goswami,

Dr. Ketan Patel, Dr. Rimpal Patel

Dr. Chetna Patel, Dr. Amita Mewada

Dr. Karishma Kazi, Dr. Nilay Patel

Dr. Ananya Debbarma

Dr. Roshani Suthar, Dr. Pooja Thakkar

Dr. Shefali, Dr. Vinay Singh

Dr. Rachit Joshi

Dr. Vijay Goplani

Dr. K. V. Raval, Dr. Toral Goswami,

Dr. Ketan Patel, Dr. Rimpal Patel

Dr. Chetna Patel, Dr. Amita Mewada

Dr. Karishma Kazi, Dr. Nilay Patel

Dr. Ananya Debbarma

Dr. Roshani Suthar, Dr. Pooja Thakkar

Dr. Shefali, Dr. Vinay Singh

Accomodation &

Transport Committee :

Accomodation &

Transport Committee :

Convenor

Co-Convenor

Convenor

Co-Convenor

Dr. R. A. Amin

Dr. Paresh Prajapati

Dr. Saurin Sanghavi

Dr. R. A. Amin

Dr. Paresh Prajapati

Dr. Saurin Sanghavi

Stage Committee :Stage Committee : Dr. Toral Goswami, Dr. Rimpal PatelDr. Toral Goswami, Dr. Rimpal Patel

Accomodation :

We recommend accomodation at Premnagar Ashram, having Holy river Gangaji's Ghat inside the Ashram, as there's no need of A.C. in December at Haridwar.

Those who want Hotels for accomodation can book themselves using online facilities or other sources. Those who are willing to have accommodation in Premnagar Ashram (Twin Bed - Attached toilet -Non AC Room ) charges will be Rs. 500 per person per day.

Breakfast & Lunch (Both Days) Dinner (1st day only) will be provided by organizers on conference days.

We recommend accomodation at Premnagar Ashram, having Holy river Gangaji's Ghat inside the Ashram, as there's no need of A.C. in December at Haridwar.

Those who want Hotels for accomodation can book themselves using online facilities or other sources. Those who are willing to have accommodation in Premnagar Ashram (Twin Bed - Attached toilet -Non AC Room ) charges will be Rs. 500 per person per day.

Breakfast & Lunch (Both Days) Dinner (1st day only) will be provided by organizers on conference days.

2

About IJBAP :

International Journal Of Basic And Applied Physiology (IJBAP) is an Annual peer-

reviewed International Medical journal, which has earned great reputation within short time. It

is being published as per MCI norms & indexed in several agencies recognized by MCI. It is

owned by SB P. The Journal welcomes original research papers in all areas of Physiology.

Last date of submission of paper- 15th october 2018. For more details and submission

visit www.ijbap.com. The Journal does not charge any fees from authors/scientists.

A

International Journal Of Basic And Applied Physiology (IJBAP) is an Annual peer-

reviewed International Medical journal, which has earned great reputation within short time. It

is being published as per MCI norms & indexed in several agencies recognized by MCI. It is

owned by SB P. The Journal welcomes original research papers in all areas of Physiology.A

Last date of submission of paper- 15th october 2018. For more details and submission

visit www.ijbap.com. The Journal does not charge any fees from authors/scientists.

Declaration of following National Awards for Important

Achievements in Scientific field :

1) National Award for the best and unique innovation in any scientific field

2) National Award for Lifetime achievement as the best scientist in Physiology

3) National Award for the best young scientist of the year. (Age below 45 years)

4) National Award for the best teacher in Physiology

5) National Award for the best social services by a Physiologist

1) National Award for the best and unique innovation in any scientific field

2) National Award for Lifetime achievement as the best scientist in Physiology

3) National Award for the best young scientist of the year. (Age below 45 years)

4) National Award for the best teacher in Physiology

5) National Award for the best social services by a Physiologist

Respected Elder Physiologists and Younger Colleagues, Jay Bharat Varsh.In our Culture and Religion ; it is said-"PANCH TYAN PARMESHWAR" and so no one should

never touch money/assets of the PANCH .A society is a PANCH, village Panchayat is a PANCH, Government ( state or central) is a

PANCH .An association or a conference is also a PANCH. A NGO is a PANCH, a Scientific Journal is

also a PANCH.The very purpose of foundation of the society of basic and applied Physiology, was to

establish the highest standards of ethics and moral values in scientific field of Physiology. Because we had seen people "Eating away lakhs of Rupees" in the name of conferences! We had seen" Fake Journals, Fake Research articles and even fake research!"

All these must stop. For stopping fake research and publications of fake materials and for prevention of corrupt practices in scientific field; we must provide true scientific platforms to the young scientists and physiologists. This was the main purpose of foundation of " Society of Basic and Applied Physiology" as well as the purpose of the foundation of the " International Journal of Basic and Applied Physiology" which has been successful in establishing very high standards of ethics and moral values in the field of scientific publications.

In continuation of the above purpose, we have decided to organize " 4 INTERNATIONAL CONFERENCE ON BASIC AND APPLIED PHYSIOLOGY" on 22-23 December 2018 at Haridwar, Uttarakhand, one of the most holy places in Bharat Varsh.

Respected Elder Physiologists and Younger Colleagues, Jay Bharat Varsh.In our Culture and Religion ; it is said-"PANCH TYAN PARMESHWAR" and so no one should

never touch money/assets of the PANCH .A society is a PANCH, village Panchayat is a PANCH, Government ( state or central) is a

PANCH .An association or a conference is also a PANCH. A NGO is a PANCH, a Scientific Journal is

also a PANCH.The very purpose of foundation of the society of basic and applied Physiology, was to

establish the highest standards of ethics and moral values in scientific field of Physiology. Because we had seen people "Eating away lakhs of Rupees" in the name of conferences! We had seen" Fake Journals, Fake Research articles and even fake research!"

All these must stop. For stopping fake research and publications of fake materials and for prevention of corrupt practices in scientific field; we must provide true scientific platforms to the young scientists and physiologists. This was the main purpose of foundation of " Society of Basic and Applied Physiology" as well as the purpose of the foundation of the " International Journal of Basic and Applied Physiology" which has been successful in establishing very high standards of ethics and moral values in the field of scientific publications.

In continuation of the above purpose, we have decided to organize " 4 INTERNATIONAL CONFERENCE ON BASIC AND APPLIED PHYSIOLOGY" on 22-23 December 2018 at Haridwar, Uttarakhand, one of the most holy places in Bharat Varsh.

Editor in Chief : Dr. R. Dixit

Editor : Dr. Jasmin Diwan

Editor in Chief : Dr. R. Dixit

Editor : Dr. Jasmin Diwan

Awards consist of cash amount of Rs.11,000/- A Gold plated citation to be handed over at conference.Awards consist of cash amount of Rs.11,000/- A Gold plated citation to be handed over at conference.

Eligibility Criteria : All nominees will be selected and declared amongst the delegates & Members of the SBAP only. Eligibility Criteria : All nominees will be selected and declared amongst the delegates & Members of the SBAP only.

THTH

3

Theme of the Conference : "CLINICAL PHYSIOLOGY"

1) Health-Check up Clinics

2) Hypnotherapy and Yoga Therapy

3) NCV and EMG Laboratories and doing tests regularly on patients.

4) EEG, Polyrite and autonomic function tests on patients.

5) TMT Laboratory, 2D Echo Tests.

6) Sleep Laboratory and sleep studies on patients

7) Intra-operative neurophysiological monitoring.

8) Pulmonary function tests regularly to be done in patients.

1) Health-Check up Clinics

2) Hypnotherapy and Yoga Therapy

3) NCV and EMG Laboratories and doing tests regularly on patients.

4) EEG, Polyrite and autonomic function tests on patients.

5) TMT Laboratory, 2D Echo Tests.

6) Sleep Laboratory and sleep studies on patients

7) Intra-operative neurophysiological monitoring.

8) Pulmonary function tests regularly to be done in patients.

Developing clinical physiology skills amongst the young physiologist like:Developing clinical physiology skills amongst the young physiologist like:

These skills are the key to success and survival of physiology as a prominent subject in

medical world.

So, we invite you all including senior faculties, PG students and young physiologists to be

witness of an event which might be an important turning point in history of physiology

discipline. Organizing the whole event, is being executed in a very transparent manner, taking

care of minimum expenses to the delegates and giving them an international scientific platform.

We want to welcome you in a land of the birth place of the greatest emperor of Bharat Varsh

and real Father of the Nation "BHARAT VARSH"; Emperor Bharat which is 77 km from Haridwar,

near Kotdwar, "The Kanva Ashram".

As we know, Shakuntla was the daughter of Rishi Vishwamitra and was raised and brought

up in the Ashram of "Kanva Rishi". She married to King Dushyant who was a Chandravanshi

kshatriya King. Prince Sarva Daman was born at Kanva Ashram to mother shakuntala.

When Sarva Daman became 12 years old, there was a Yagna going on at Ashram. A violent

lion came and attacked on the gathering of yagna. Young boy "Sarva Daman" caught the lion at

his neck and controlled the lion like a cow and prevented him from attacking the yagna.

When Sarvadaman became king after the death of King Dushyant, he conquered a vast

land through many battles and he achieved "Vishwa Vijay" in most of the South East Asia.

When he was coronated as the Emperor, his name was changed to "Bharat" ( The most

decorated person in Sanskrit) and the vast land conquered by him was named as "Bharat

Varsh". Thus Emperor Bharat is the real and only "Father of the Nation-BHARAT VARSH".

On basis of description in ancient text Adi Parva, the areas included currently in Bharat

Khand are following:

Afghanistan, Bangladesh, Bharat, Pakistan, Nepal, Bhutan, Maldives, Srilanka, Myanmar

Kanva Ashram (77km from Haridwar, 6 km from Kotdwar), is the birth place of the Real

Father of the Nation. It was the most important Tirth of my life when I visited the "Kanva

Ashram".

These skills are the key to success and survival of physiology as a prominent subject in

medical world.

So, we invite you all including senior faculties, PG students and young physiologists to be

witness of an event which might be an important turning point in history of physiology

discipline. Organizing the whole event, is being executed in a very transparent manner, taking

care of minimum expenses to the delegates and giving them an international scientific platform.

We want to welcome you in a land of the birth place of the greatest emperor of Bharat Varsh

and real Father of the Nation "BHARAT VARSH"; Emperor Bharat which is 77 km from Haridwar,

near Kotdwar, "The Kanva Ashram".

As we know, Shakuntla was the daughter of Rishi Vishwamitra and was raised and brought

up in the Ashram of "Kanva Rishi". She married to King Dushyant who was a Chandravanshi

kshatriya King. Prince Sarva Daman was born at Kanva Ashram to mother shakuntala.

When Sarva Daman became 12 years old, there was a Yagna going on at Ashram. A violent

lion came and attacked on the gathering of yagna. Young boy "Sarva Daman" caught the lion at

his neck and controlled the lion like a cow and prevented him from attacking the yagna.

When Sarvadaman became king after the death of King Dushyant, he conquered a vast

land through many battles and he achieved "Vishwa Vijay" in most of the South East Asia.

When he was coronated as the Emperor, his name was changed to "Bharat" ( The most

decorated person in Sanskrit) and the vast land conquered by him was named as "Bharat

Varsh". Thus Emperor Bharat is the real and only "Father of the Nation-BHARAT VARSH".

On basis of description in ancient text Adi Parva, the areas included currently in Bharat

Khand are following:

Afghanistan, Bangladesh, Bharat, Pakistan, Nepal, Bhutan, Maldives, Srilanka, Myanmar

Kanva Ashram (77km from Haridwar, 6 km from Kotdwar), is the birth place of the Real

Father of the Nation. It was the most important Tirth of my life when I visited the "Kanva

Ashram".

4

Friends, Society of Basic and Applied Physiology has become the symbol of honesty, hard work

and transparency in scientific world of our nation especially due to successful publication of its

prestigious journal- "International Journal of Basic and Applied Physiology". It has established the

highest standards of ethics and moral values in the field of Physiology. Your active cooperation and

acceptance has played key role in this great success.

From this year, we are introducing beginning of 5 National awards in Physiology. In this series of

bold, unique step ahead, Society of Basic and Applied Physiology has organized a unique "4th

International Conference of Basic and Applied Physiology 2018" at Prem Nagar Ashram, Haridwar,

Uttarakhand.

Haridwar is a natural national centre with rich spiritual, historical and tourist attractive places

where you feel great and satisfied when you visit. You can come with family (who can arrange their own

itinerary in groups).

It will be a great experience having the valuable presence of delegates from entire country and we

hope to have presence of few foreign delegates also .

Friends, Society of Basic and Applied Physiology has become the symbol of honesty, hard work

and transparency in scientific world of our nation especially due to successful publication of its

prestigious journal- "International Journal of Basic and Applied Physiology". It has established the

highest standards of ethics and moral values in the field of Physiology. Your active cooperation and

acceptance has played key role in this great success.

From this year, we are introducing beginning of 5 National awards in Physiology. In this series of

bold, unique step ahead, Society of Basic and Applied Physiology has organized a unique "4th

International Conference of Basic and Applied Physiology 2018" at Prem Nagar Ashram, Haridwar,

Uttarakhand.

Haridwar is a natural national centre with rich spiritual, historical and tourist attractive places

where you feel great and satisfied when you visit. You can come with family (who can arrange their own

itinerary in groups).

It will be a great experience having the valuable presence of delegates from entire country and we

hope to have presence of few foreign delegates also .

Thanking You.

Dr. Jayendrasinh Jadeja

Thanking You.

Dr. Jayendrasinh Jadeja

PREMNAGAR ASHRAM

Great opportunity to

have "Ganga Snan" within the

Premnagar Ashram premises.

Great opportunity to

have "Ganga Snan" within the

Premnagar Ashram premises.

Lord Shiva and Lord Vishnu are believed to have visited the Brahmakund in Har Ki Pauri in the Vedic times.

Lord Shiva and Lord Vishnu are believed to have visited the Brahmakund in Har Ki Pauri in the Vedic times.

Patanjali Yogpeeth in Haridwar, Uttarakhand, is one of the largest yoga institutes in India, possibly the whole world. Named after the Rishi Patanjali, the institute is Baba Ramdev's flagship project. Its purpose is to practise and research and develop yoga and ayurveda, as well as manufacture ayurvedic medicines. It is also the home of the University of Patanjali. Acharya Balkrishna is the General Secretary of Patanjali Yogpeeth

Patanjali Yogpeeth in Haridwar, Uttarakhand, is one of the largest yoga institutes in India, possibly the whole world. Named after the Rishi Patanjali, the institute is Baba Ramdev's flagship project. Its purpose is to practise and research and develop yoga and ayurveda, as well as manufacture ayurvedic medicines. It is also the home of the University of Patanjali. Acharya Balkrishna is the General Secretary of Patanjali Yogpeeth

Headqurter of Gayatri Parivar. Shantikunj has emerged over the years as a unique center and fountain-head of a global movement of Yug Nirman Yojna (Movement for the Reconstruction of the Era) for moral-spiritual regeneration in the light of Indian heritage

Headqurter of Gayatri Parivar. Shantikunj has emerged over the years as a unique center and fountain-head of a global movement of Yug Nirman Yojna (Movement for the Reconstruction of the Era) for moral-spiritual regeneration in the light of Indian heritage

Rishikesh is a city of Uttarakhand. Located in the foothills of the Himalayas in northern India, it is known as the 'Gateway to the Garhwal Himalayas and 'Yoga Capital of the World'. It is known as the pilgrimage town and regarded as one of the holiest places of Hindus. Hindu sages and saints have visited Rishikesh since ancient times to meditate in search of higher knowledge

Rishikesh is a city of Uttarakhand. Located in the foothills of the Himalayas in northern India, it is known as the 'Gateway to the Garhwal Himalayas and 'Yoga Capital of the World'. It is known as the pilgrimage town and regarded as one of the holiest places of Hindus. Hindu sages and saints have visited Rishikesh since ancient times to meditate in search of higher knowledge

PATANJALI YOGPEETH

HAR KI PAUDI

SHANTI KUNJ ASHRAM

RISHIKESH

5

KEDARNATH

Kçdârnâth Mandir (Kedarnath Temple) is a Hindu temple dedicated to Lord Shiva. It is on the Garhwal Himalayan range near the Mandakini river in Kedarnath, Uttarakhand in India. Due to extreme weather conditions, the temple is open only between the end of April (Akshaya Tritriya) to November (Kartik Purnima - the autumn full moon). During the winters, the vigrahas (deities) from Kedarnath temple are brought to Ukhimath and worshipped there for six months. Lord Shiva is worshipped as Kedarnath, the 'Lord of Kedar Khand', the historical name of the region.

Kçdârnâth Mandir (Kedarnath Temple) is a Hindu temple dedicated to Lord Shiva. It is on the Garhwal Himalayan range near the Mandakini river in Kedarnath, Uttarakhand in India. Due to extreme weather conditions, the temple is open only between the end of April (Akshaya Tritriya) to November (Kartik Purnima - the autumn full moon). During the winters, the vigrahas (deities) from Kedarnath temple are brought to Ukhimath and worshipped there for six months. Lord Shiva is worshipped as Kedarnath, the 'Lord of Kedar Khand', the historical name of the region.

MUSSOORIE

It has a nature walk known as "Camel's Back Road". This road takes its name from a rocky outcrop in the shape of a camel's hump. The road contains hotels and motels, and a cemetery is about mid-way on the loop. Company Garden a tourist attraction, has a large collection of flowers and plants.

It has a nature walk known as "Camel's Back Road". This road takes its name from a rocky outcrop in the shape of a camel's hump. The road contains hotels and motels, and a cemetery is about mid-way on the loop. Company Garden a tourist attraction, has a large collection of flowers and plants.

NAINITAL

Nainital is a Himalayan resort town in the Kumaon region of India's Uttarakhand

state, at an elevation of roughly 2,000m. Formerly a British hill station, it's set around

Nainital Lake, a popular boating site with Naina Devi Hindu Temple on its north shore.

Nainital is a Himalayan resort town in the Kumaon region of India's Uttarakhand

state, at an elevation of roughly 2,000m. Formerly a British hill station, it's set around

Nainital Lake, a popular boating site with Naina Devi Hindu Temple on its north shore.

Badrinath is a holy town and a nagar panchayat in Chamoli district in the state of Uttarakhand, India. It is the most important of the four sites in India's Char Dham pilgrimage and gets its name from the temple of Badrinath. Badrinath or Badrinarayan Temple is a Hindu temple dedicated to Vishnu, which is situated in the town of Badrinath in Uttarakhand, India.

Badrinath is a holy town and a nagar panchayat in Chamoli district in the state of Uttarakhand, India. It is the most important of the four sites in India's Char Dham pilgrimage and gets its name from the temple of Badrinath. Badrinath or Badrinarayan Temple is a Hindu temple dedicated to Vishnu, which is situated in the town of Badrinath in Uttarakhand, India.

BADRINATH

Ex. Dean Dr. B. J. Shah, Dr. J. M. Jadeja, Prof. & HOD, Faculty Members & PG Students of Physiology Dept.B. J. Medical Collage, Ahmedabad

Ex. Dean Dr. B. J. Shah, Dr. J. M. Jadeja, Prof. & HOD, Faculty Members & PG Students of Physiology Dept.B. J. Medical Collage, Ahmedabad

6

Year-2012Year-2012

SOCIETY OF BASIC AND APPLIED PHYSIOLOGY IS ORGANIZING


(H.Q. Department of Physiology, B. J. Medical College, Ahmedabad)

ICON BAP-2018 at Haridwar, Uttarakhand

For Latest updates visit our group on Face book: "International conference on Basic and Applied Physiology"

EMAIL- [email protected], CONTACT : Dr. Saurin Sanghavi_98257 68604, Dr. Paresh Prajapati_99247 97300

SEND SCANNED COPY OF BANK RECEIPT AND CHEQUE /RTGS-NEFT TRANSFER TO ABOVE E-MAIL

Delegate Signature

Details of NEFT/RTGS transfer :

Account Name

Account No.

Bank Name

IFS Code


: 912010041533674


: UTIB0000449

Name :

(First Name) (Middle Name) (Last Name)

Age : Gender :

Educational Qualification :

Designation :

Institution :

Correspondent Address :

Mobile Number :

E mail ID :

MCI/State council Registration no.:

Delegate Status : Delegate Associate Guest

PG Student Foreign & NRI Delegate

Accompanying Person:

Name: Age : Gender :

(1)

(2)

TH

Mode of Payment:

Cheque /D.D. Cash RTGS/NEFT Debit / Credit Card

Accomodation required at Ashram : Yes / No If yes than Date :

Charges : 500 INR per person per day on twin sharing basis.

(h.q. department of physiology, b. j. medical college ... · state, at an elevation of roughly...

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