PAPER / POSTER SUBMISSION FORM

Indo-US
EMERGENCY MEDICINE SUMMIT-2006

 The Organising Committee of INDUS-EM 2006 invites papers /Clinico-pathological Case/posters regarding presentation and research forum / poster presentation (related to research:
 emergency care) interesting cases in any field of emergency medicine.

  Title Prof./Dr./Mr./Mrs./Ms.  ..................................................................................................

First  Name                           ...................................................................................................

Last Name                            ......................................................................................................

Department                           ......................................................................................................

Institution                              ......................................................................................................

Postal Address                      ....................................................................................................

                                             ............ ......................................................................................

City .............................................. Country .................................. Postal Code.......................

Telephone ..........................................................(O) ............................................................(R)

Fax ............................................................. Mobile ................................................................

Email ....................................................................................................................................

                                                 Conference Secretariat         

Faculty Room, Division of Emergency Medicine,
All India Institute of Medical Sciences, New Delhi-110029
Tel: 011-26588500, 26588700 Ext. 3365, 26589029 (Direct);
Fax: 26588663, 26588641;  Email: indusem2006@yahoo.co.in