Offline Registration Form

First Annual National Scientific Conference of

Epidemiology Foundation of India

(EFICON-2020)

11^th – 12^th APRIL, 2020

Registration Form

1. Name:                 First:                            Last:

2. Designation:

3. Institution/Organization Address:

4. Complete Address for correspondence:

5. Contact No.  Mobile:                           Landline:                               

6. Email ID:

7. Abstract Submitted        :         Yes/No,       If yes    :         Oral/Poster  

Signature:______________________

Name of the Presenter:

Date:                          

Address for Correspondence

Dr. Pradeep Aggarwal

Joint Organizing Secretary &

Associate Professor

Department of Community and Family Medicine

All India Institute of Medical Sciences, Rishikesh, Uttarakhand

Email: eficon2020-aiims-rishikesh@gmail.com

Ph: +91- 9837215747