23Rd Annual Conference of Association of Rural Surgeons of India (ARSI)

Combined 6th International Conference of International Federation of Rural Surgery (IFRS) & 23rd Annual Conference of Association of Rural Surgeons of India (ARSI) Registration Form

Medical Reg. No.:------Personal Details (Please Use BLOCK LETTERS) Surname ______First ______Age ___ Sex M/F_ Title (Professor / Dr / Mr / Mrs / Ms) :______Name as you wish it to appear on your Conference Badge Food Veg. Institution / Organization ______Non Veg. Mailing Address______City______Postal Code Tel. No. Res. ______Tel. No. Clinic Mobile No.______Email : Accompanying Persons ______Age Sex M/F ______Age Sex M/F ______: Age Sex M/F

[ ~~1 I need a letter of invitation for official permission / visa formalities Registration Fees Before 30th Before 30th After 30th June, 2015 September, September, ARSI member Indian Rs 3000 Rs 3500 Rs 4000 Accompanyingdelegate person Rs 2000 Rs 2500 Rs 3000 IFRS member USD 80 USD 90 USD 100 IFRS accompanying USD 60 USD 70 USD 80 Non ARSI member Rs 3500 Rs 4000 Rs 4500 Non IFRS Member USD 90 USD 100 USD 110 Post graduates Rs 2000 Rs 2500 Rs 3000 (certificate required) Child from 4-12 yrs Rs 1000 Rs 1500 Rs 2000 Pre Conference CME Pediatric Surgery Live, Video session symposia, guest lecture Reg. Fee Rs. 750/- Category : Total Rs. Draft No______Drawn on ______Dated ------Amount Rs. ______*DDs or Cheques drawn in favour of “ARSICON.2015", payable at par. For Electronic Transfer Name: ARSICON.201 5 Bank of India Account no. 1 3 1 4 2 0 1 1 0 0 0 0 2 8 0 IFS Code: B K I D 0 0 0 1 3 1 4 MICR Code : 4 1 5 0 1 3 5 2 3 Overseas delegates should pay the registration fees only in Indian Rupees equivalent to USD. Faculties – General surgery, Orthopaedics, ENT, Obstetrics&Gynaecology, Ophthalmology and Anaesthesia Conference Secretariat KRISHNA INSTITUTE OF MEDICAL SCIENCES UNIVERSITY, KARAD, SATARA, MAHARASHTRA, INDIA. Contact: 02164-241555/6/7/8 Email : [email protected] www.arsi-india.org, www.kimsuniversity.in Combined 6th International Conference of International Federation of Rural Surgery (IFRS) & 23rd Annual Conference of Association of Rural Surgeons of India (ARSI) Abstract Submission Deadline for abstract submission - 30th September, 2015 Registration Compulsory for Paper Presentation Abstracts preferably should be sent online or by email to : [email protected]

Paper presentation

Title :

Presenting Author

E-mail Co Authors Institution

Three Mistakes in Surgical Practice in three minutes Presentation of three mistakes in my surgical practice in three minutes (confession)

“ “How do I do it”

1 Introduction: (250 words maximum. Font- Times New Roman, 10pt)

2 Materials and Methods:

3 Observations:

4 Conclusions: Conference Secretariat KRISHNA INSTITUTE OF MEDICAL SCIENCES UNIVERSITY, KARAD, SATARA, MAHARASHTRA, INDIA. Contact: 02164-241555/6/7/8 Email : [email protected] www.arsi-india.org, www.kimsuniversity.in