Workshop Registration

Workshops Registration

FIRST NAME *

LAST NAME *

PREFERED NAME ON CERTIFICATE *

POSITION *

INSTITUITION / MEDICAL COLLEGE *

ADDRESS

MOBILE NO. *

EMAIL *

QUALIFICATIONS *

PMDC REGISTRATION / IRSP MEMBERSHIP NUMBER.

PAYMENT RECEIPT *

Click or drag a file to this area to upload.

Registration Fee:
• Prior Registration is mandatory, each workshop requires a separate registration.
• Fee should be deposited in the given account and the snapshot uploaded with the registration form.
• Payments may be done by Online / ATM / Bank Transfer:

IRSP Account Title: Interventional Radiology Society of Pakistan
Account No.: 5004-0081-001096-01-7
IBAN No.: PK70BAHL5004008100109601
Swift Code: BAHLPKKA
Bank: Al-Habib Islamic Banking Branch Memon Medical Institute, Karachi

Workshop Registration

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