MID DERMACON 2026 Registration

If you have already registered Abstract Submission Click Here

Upload Photo*

Category*

HOD Letter Upload *

Upload ID Proof (Aadhaar Card,PAN Card,Driving License,Passport)*

State Medical Council Number*

State Medical Council*

Title *

First Name*

Last Name*

Email*

Name as to appear on badge*

Designation

Gender *

Date Of Birth

Age*

Current Affiliation / Institution *

Mobile No.*

Telephone No.

Meal Preferences *

Address*

Country*

City *

Postal code*

State*

Indian Delegate

Foreign Delegate

Accompanying Person

Select Workshop (Video) (Each)	Select Master Class (Each)

PARTICULARS	AMOUNT
Registration Fee
Workshop Fee
Master Class Fee
Gala Dinner Charge
Cost of Accompanying Person(s)
Banquet Cost
CGST (9%)
SGST (9%)
TOTAL COST
GST (18%)
GRAND TOTAL
2.5% Bank Charges

Total Amount Payable:

Mode of payment

Account Name	IADVL
Account Number	44838564004
Bank Name	STATE BANK OF INDIA
IFSC Code	SBIN0003313
Branch	Patrapada Branch
Branch Address	Kalinga Nagar, AT and PO, Patrapada Stateorissa, Khurda 751019, Bhubaneswar, Odissa