Workshop Registration

Name*

Father / Husband Name

Age

PMDC No*

Cell / Telephone No*

I.D Card No*

Address*

Qualification*
FCPSFRCSConsultantTrainee

Hospital Experience*
ERCPColonoscopyEUSPrior ExperienceYesNoOther

Applied for*
Hands onObserver

No of Year Experience (ERCP, Colonoscopy, EUS)*

Current Organization/Institute*

Attached Documents*
CVNOCReferral Letter From Supervision

File Upload*

Account Detail

Title: Sindh Institute of Advanced Endoscopy and Gastroenterology (Donation)

IBAN: PK39FAYS3407787000003738

Account #: 3407787000003738

Faysal Islamic Bank Limited

Note: Please note that charges must be paid only after receiving a confirmation email. Failure to do so may result in non-refundable payment.