TWO DAY NATIONAL SEMINAR
ON
BIOETHICS

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Registration Form

Name
Designation
Age
Sex	(Male/Female)
Organization /College
Address
Phone No
E-mail
Registration as	Delegate/Student Delegate
Enclosed cash / DD / Cheque No.
Dated
of Rs.
(Drawn in favors of Principal, V.P.M’s Joshi-Bedekar College, Seminar A/c, Thane, Payable at Thane)