ATLS - Advanced Trauma Life Support India Program

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19

October, 2024

Microsoft Word - ATLS-registration-form

AIIMS

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

Year of Post Graduation

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

COURSES FOR TRAUMA, AND RESEARCH

TRAUMA IN RESEARCH AND TEACHING.

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