REGISTRATION FORM

Registration Status

Open

Bank Details

Account Title : Pakistan Society of Haematology
Account Number : 0084607010000082
Bank Name : MCB
Branch Name : CMH
Branch Code : 0846
City : Rawalpindi

Important Note

Only ATM/Bank Deposit/Mobile Banking will be accepted. For any query please call at +923225181302 or email on psh.org.pk@gmail.com

Full Name

Designation

Affiliation

Cell No.

Registration Fees	Normal
Conference: Consultant	PKR 5000
PGs, Lab Tech, Nurses & Allied	PKR 2500
Gala Dinner: Yes No	PKR 1000
Accompanying(s) 1 2 3 Non	PKR 2000 each
Total Fee to Deposit PKR

CNIC No.

CPSP ID/Fellowship No./PMDC No.

Mode of Payment
Slip No:
Attached Slip Picture (jpg)
Deposit Date