ATLS India

18-20

October, 2024

Microsoft Word - ATLS-registration-form

AIIMS, Jodhpur

Description

ADDRESS INFORMATION
Dr. Madhur Uuiyal Associate Professor
Trauma Surgeryl AIIMS Rishikesh 249203 Uttarakhand

E-mail: - atls@aiimsrishikesh.edu.in

COURSE FEE DETAILS:

Fees Information

Participants from India & SAARC Countries - Rs 21500
Doctors in Govt. Services & Armed forces - Rs. 16500
Resident Doctors - Rs. 11500
Other Foreign Nationals - USD 600

Submit proof along with the registration form.

PLEASE PROVIDE THE FOLLOWING CONTACT INFORMATION

Please give your option for ATLS Provider Course :

Option A

Option B

Name

Title

Age

Designation

Speciality

Year of Graduation

Post Graduate Qualification (Optional)

Year of Post Graduation (Optional)

Hospital

Full Address

Communication

Zip/Postal Code

Country

Work Phone

FAX

Mobile

Date of any ATLS Provider course attended along with the registration number

Date of any ATLS Instructor course attended along with the registration number

Are you interested in and available for the Instructor course? (Please note that you must successfully complete the Student Course and be identified as having instructor potential to attend the Instructor Course) Yes No

Submit Application

18-20

Microsoft Word - ATLS-registration-form

Description

PLEASE PROVIDE THE FOLLOWING CONTACT INFORMATION

Important Links

Quick Links

Contact Us

Course Detail

18-20

Microsoft Word - ATLS-registration-form

Description

PLEASE PROVIDE THE FOLLOWING CONTACT INFORMATION