INDIAN BOARD OF ALTERNATIVE MEDICINES
International Congress,
Convocation & Award Presentation Ceremony
1st & 2nd December 2005, Open Center Calcutta

REGISTRATION FOR DELEGATES

Name:

Sex:

Nationality:

Qualification/Titles:

Street:

City:

State:

Country

Zip

Telephone

Fax:

E-mail:

Website:

Currency:

Payment Details:-Bank Name:

Payment Mode:

No:

Amount:

Dated:

I wish to read a paper on:

In case of student, please type in your Roll No. and the course name,so that your certificate can be kept ready to be presented during the convocation.