ABSMIDS Intl Conference 2025

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Banquet Registration

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* Fields are mandatory

* Are you an Alumni of this College :

Yes

No

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* Registration Type :

Banquet

Select Registration Type

Title :

Prof.

Dr.

Mr.

Ms.

Mrs.

Select Title

* Name :

Enter Name

* Gender :

Male

Female

Select Gender

* Hospital/Organisation :

Enter Hospital/Organisation

* Email Id :

Enter Email Id Enter Valid Email Id

* Mobile Number :

Enter Mobile Number Enter Valid Mobile Number

* Food Preference :

Veg

Non-Veg

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Any other Comments / Request :

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