4th ACNS Interim Meeting, Dhaka, Bangladesh

Registration Form ( * marked are required)

Resident OR Neuro Surgeons

⚠ Select Payment Method : *

bKash

Bank Transfer

Cash

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YES

Bank Name:	PUBALI BANK PLC.
Branch Name:	SHAHBAGH AVENUE BRANCH, DHAKA, BANGLADESH
Account Name:	BANGLADESH SOCIETY OF NEUROSURGEONS
Account Number:	0947101107409
Routing Number:	175276222
Swift Code:	PUBABDDH
Payable Amount:	RESIDENT : BDT 2000/-NEUROSURGEONS : BDT 6000/-

Bkash Number :	01879546130
Bkash Name :	Name of Bkash Account
Reference :	4thACNS
Payable Amount:	RESIDENT : BDT 2040/-NEUROSURGEONS : BDT 6120/-

Booth :	BSNS office.
Payable Amount:	RESIDENT : BDT 2000/-NEUROSURGEONS : BDT 6000/-

Registration Form ( * marked are required)

Bank Transfer / Deposit

Bank Name:

PUBALI BANK PLC.

Branch Name:

SHAHBAGH AVENUE BRANCH, DHAKA, BANGLADESH

Account Name:

BANGLADESH SOCIETY OF NEUROSURGEONS

Account Number:

0947101107409

Routing Number:

175276222

Swift Code:

PUBABDDH

Payable Amount:

RESIDENT : BDT 2000/-NEUROSURGEONS : BDT 6000/-

Pay by Bkash

Bkash Number :

01879546130

Bkash Name :

Name of Bkash Account

Reference :

4thACNS

Payable Amount:

RESIDENT : BDT 2040/-NEUROSURGEONS : BDT 6120/-

Pay by Cash

Booth :

BSNS office.

Payable Amount:

RESIDENT : BDT 2000/-NEUROSURGEONS : BDT 6000/-

Registration Form ( * marked are required)Payment Method (s)

Bank Transfer / Deposit

Bank Name:

PUBALI BANK PLC.

Branch Name:

SHAHBAGH AVENUE BRANCH, DHAKA, BANGLADESH

Account Name:

BANGLADESH SOCIETY OF NEUROSURGEONS

Account Number:

0947101107409

Routing Number:

175276222

Swift Code:

PUBABDDH

Payable Amount:

RESIDENT : BDT 2000/-NEUROSURGEONS : BDT 6000/-

Pay by Bkash

Bkash Number :

01879546130

Bkash Name :

Name of Bkash Account

Reference :

4thACNS

Payable Amount:

RESIDENT : BDT 2040/-NEUROSURGEONS : BDT 6120/-

Pay by Cash

Booth :

BSNS office.

Payable Amount:

RESIDENT : BDT 2000/-NEUROSURGEONS : BDT 6000/-

Registration Form ( * marked are required)