AMOGS Registration

Registration Form
Membership Type:

Discount of 1000/- to all Post Graduate Students (Except Spot Registration)
Last Name *
First Name *
Middle Name
Your Email *
Mobile*
Tel. Residence
Clinic Phone No.
Date Of Birth
Your Address
City*
State*
State Code*

MMC Registration No.*
N.B. FOGSI Category
GSTIN
N.B. FOGSI Category is as follows:

Category-A: Member with a Post Graduate qualification in Obstetic & Gynaecology Degree, Diploma, Membership or Fellowship.

Category-B: Non-Post Graduate members with MBBS qualification.
Payment Method & Details


Appropriate GST will be charged Extra.
Delegate Fee -
Hospitality Charges

Please select Workshop from below list
Workshop Name:


Accompanying person details
No. of Persons
No. of Person for Banquet
No. of Person for Reception Community Dinner
Accompanying Person's Total Fee

Sub-Total (A) -CGST 9% -SGST 9% -Sub-Total (B) [GST]₹ 7,500Total (A+B)-

Payment Method & Details


Bank*
Branch*
Date*
Cheque / Draft No. / NEFT Transaction No. / Receipt No.*
POGS Bank details for NEFT
Title of Account :
POGS AMOGS 2018 Conference
Name of Bank :
Bank of Maharashtra, Tilak Road Branch, Pune
A/C. No. :
00000060278553916
IFS Code :
MAHB0000100
Secure Code*
captcha
* Fileds are mandatory.