Registration Details

Name of Delegate

Gender

EIZOC Membership No (Optional)

Name of Associate delegate/Spouse/PG (1)

Name of Associate delegate/Spouse/PG (3)

Name of Associate delegate/Spouse/PG (2)

Name of Associate delegate/Spouse/PG (4)

Contact No

Email Address (Optional)

City

State

Pincode

Registration Category

Transaction Details

Registration Amount (Cumulative as per Brochure).

Transaction Date (dd-mm-yyyy)

Transaction ID

Remarks (if any)

Instruction

Please make the payment before applilcation and give the Transaction number in application form

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Members

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Bank Details

Account Name : Opthalmological Sociery of West Bengal
Bank Detail : Indian Overseas Bank, Dharamatolla Street
A/C No : 058601000020756
IFSC Code : IOBA0000586
MICR Code : 700020023
Swift Code : IOBAINBB585
PAN : AAAAO0602P
GSTN : 19AAAAO0602PP1Z1

SCAN to Pay fron any UPI App

Registration Fee Details

Category	Early Bird	Regular	Spot
Category	till 22-Sep-2024	till 31-Oct-2024	01-Nov-2024 to Spot
Members >70Yrs & Past Presidents	--	--	--
Members	5310/-	6490/-	8260/-
Spouse, Child >12Yrs & Residents	4720/-	5900/-	7080/-
Non Members	7080/-	8260/-	10620/-
Child 6-12 Yrs	3540/-	4310/-	4720/-