Select Title*Dr.Mr.Mrs.Ms. Name to be printed as in the Certificate* Qualification* GNM BSc MSc PhD Delegate Category* Nurses and Faculty (INR: 700.00) PG Students (INR: 200.00) RN Reg.Number RM Reg.Number Name of the Institution Studying/Working* If you are working in CMC, enter Employee Number; If not enter NO* Address for Communication* City* State* Country* Contact No* EMail Address* Food Preference* VegetarianNon-Vegetarian Note: Kindly attach a proof for online transaction. Only the attachment with transaction ID will be considered for the approval of registration. Make sure it is NOT more than 350KB. Payment Ref.No* Date* Amount* CurrencyINRUSD Upload Proof of Payment* I hereby declare that the information provided above is true, complete, and correct to the best of my knowledge and belief; I accept and agree to the Terms & Conditions of the National Surgical Nursing Conference, 2023 - 2022.