Registration Form

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 Address for Correspondence                 

                                                                                                                                           

                                                           
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Payment Details                                  
Draft/Cheque No                                                    Date                               Bank         

 

Signature

 

Please mail this form to  :
Secretariat Pediatrics Malignancies,
Room No. 4004,

Department of Pediatrics,
AIIMS, New Delhi-110029

Tel No: 26593309 , 26594297
Fax: 91-11-26588641 , 26588663
profdkgupta@gmail.com ,cancersymposium@gmail.com