PAUL’S HOSPITAL

The course fee is Rupees 30,000 ($ 700 for foreign candidates). The course fee doesn’t include accommodation. Since only four candidates are taken in a batch, advanced registration is required.

Registration Form

1St Choice of date: (Refer Calendar)

2nd Choice of date:

First Name:

Surname:

Date of Birth:

Address

Name of Institutions

Designation

Tel No: Office :

Residence :

Fax No:

E. Mail:

Qualifications:

Year

Degree

Institutions

Previous Endoscopy Training if any:

Type of Endoscopy procedures presently doing: -

Facilities available at your center:

I enclose a draft for US $ 700 /Rs 30,000
(Payable to Dr. Paul P.G)

Date:
Place:		Signature

Please send to:
Dr. Paul P.G
Paul's Hospital,
Gladwin Junction,
Kaloor,
Kochi 682017.
Email: paulpg@vsnl.com
Website : www.paulpg.com
Ph: 91 484 2331797, 2335342 , 2344447 , 2344446

Download Registration Form