RSSDI 2024 - Online Registration Form
(*It is important that you provide an email & mobile number so that future communications can be sent to you via SMS/ e-mail)
Title* :
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Prof.
Dr.
Mr.
Ms.
Mrs.
First Name* :
Last Name :
Gender* :
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Male
Female
Institute/ Hospital* :
Food Preference :
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Veg
Non Veg
Designation* :
MCI No :
Email* :
Mobile* :
Postal Address * :
Country* :
State* :
City* :
PIN/ZIP Code* :
Registration Category : *
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Members INR 20000
Non Members INR 28000
PG Students INR 15000
Diabetes Educators & Dietitians INR 15000
Corporate Delegates INR 28000
International Delegates INR 30000
Membership Number *
Confirmation Certificate duly signed by HOD * (512 KB Maximum Image file)
Medical Reg. No/ Year/ State Medical Council *
Accompany Person's Details - INR 20000 Per Person (optional)
Sl
Accompanying Person Name
Gender
Age
Food Preference
1.
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Male
Female
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Veg
Non Veg
2.
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Male
Female
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Veg
Non Veg
3.
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Male
Female
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Veg
Non Veg
Register Now
* Registration amount is inclusive of GST.
