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Sri Balaji Vidyapeeth Mahatma Gandhi Medical College & Research Institute Pillaiyarkuppam, Pondicherry - 607 402 National Seminar and CME on Therapeutic Potential of Yoga Organized by Centre for Yoga Therapy, Education and Research (CYTER) and Department of Physiology, MGMC & RI Friday, 26 June 2015 Ground Floor Lecture Hall, College Block, MGMC & RI, Pondicherry Registration Form Name: …………………………………………………………………………………….…………………………………………..….……….…… Designation: ……………………………………………………...………….……………………………………….………………….…………. Mobile: ….………………..……………………………………… E. Mail:. ……………………………….……….……………………..…… Address:………….…………………………………………………..…………….…………………….…………………..……………….……… ..…..….………..……………………………..………………………………….…………………………….…………………………………. ………………………….……….………………………………………….…………………………………………….…………………………. ……………. Payment details: DELEGATE (Rs 600), STUDENT (Rs 300) ………………………………………………………….………………………………………………………………..………………………..….….. Signature ……………………………………………………………..……. Date…………………………………………..…………. The National Seminar and CME is accredited and awarded 2 credit hours by Tamil Nadu Medical Council & 10 credit points by Tamil Nadu Dr. MGR Medical University. Bank name: INDIAN BANK, Kirumampakkam Branch (913), Pondicherry Account name: Department of Physiology MGMC & RI Account number: 6272947821 IFSC Code: IDIB000K087

Registration form for the National seminar cum CME on “Therapeutic Potential of Yoga” at MGMCRI on June 26th

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Page 1: Registration form for the National seminar cum CME on “Therapeutic Potential of Yoga” at MGMCRI on June 26th

Sri Balaji Vidyapeeth

Mahatma Gandhi Medical College & Research Institute

Pillaiyarkuppam, Pondicherry - 607 402

National Seminar and CME on

Therapeutic Potential of Yoga

Organized by Centre for Yoga Therapy, Education and Research (CYTER) and Department of Physiology, MGMC & RI

Friday, 26 June 2015

Ground Floor Lecture Hall, College Block, MGMC & RI, Pondicherry

Registration Form

Name: …………………………………………………………………………………….…………………………………………..….……….……

Designation: ……………………………………………………...………….……………………………………….………………….………….

Mobile: ….………………..……………………………………… E. Mail:. ……………………………….……….……………………..……

Address:………….…………………………………………………..…………….…………………….…………………..……………….………

..…..….………..……………………………..………………………………….…………………………….………………………………….

………………………….……….………………………………………….…………………………………………….………………………….

…………….

Payment details: DELEGATE (Rs 600), STUDENT (Rs 300)

………………………………………………………….………………………………………………………………..………………………..….…..

Signature ……………………………………………………………..……. Date…………………………………………..………….

The National Seminar and CME is accredited and awarded 2 credit hours by Tamil Nadu Medical Council & 10 credit points by Tamil Nadu Dr. MGR Medical University.

Bank name: INDIAN BANK, Kirumampakkam Branch (913), PondicherryAccount name: Department of Physiology MGMC & RI

Account number: 6272947821 IFSC Code: IDIB000K087