24
1
From The Desk of Chairman, Organising Committee
Dear Colleague
It gives the greatest pleasure welcoming YOU to , a landmark event in the calendar of the This is the FIRST Annual Conference of Association of Breast Surgeons of India (ABSI)
which is being held in association with the from 18-20 May 2012. The Conference Venue is Hotel Hyderabad Marriott, a 5 star deluxe Hotel situated in the heart of Hyderabad overlooking the most beautiful Hussain Sagar Lake.
Established in 2011 as a Section of ASI, ABSI primarily represents General Surgeons, Surgical Oncologists and Plastic Surgeons practicing of the art & science of Breast surgery in India. Our Affiliate Members include Gynecologists, General Practitioners, Radiologists, Pathologists, Medical Oncologists, Radiation Oncologists & Breast Cancer Advocacy Groups, all of whom are equally important members of the Multidisciplinary Team involved in treating patients with breast disease.
Established in 1986 by a group of Breast Cancer Specialists lead by its Founder President , Prof Umberto Veronesi, has over the past 25 years been working towards improving standards of breast cancer care in Europe. This is the very FIRST time for to be associated with an Organisation in the Indian Subcontinent & I hope that this joint Congress will pave way to releasing the HYDERABAD STATEMENT, which will set the agenda - an action plan for ABSI to achieve between 2012-2013.
In many developed Countries across the world, the concept Organ based Specialists has now been firmly established. Breast Surgery is a recognised Subspecialty of General Surgery abroad with structured training for designated Breast Surgeons. The Principal goal of ABSI to standardize the delivery of Breast Healthcare in India , and equally, work towards establishing Breast Surgery as a Subspecialty in India. Hence, the theme for this International Congress is 'Breast healthcare in India - time for a paradigm change'.
The Congress will involve, engage & empower delegates about the best practices and latest advances in the art & science of Breast Surgery that would undoubtedly translate to achieving best outcomes that our patients so richly deserve. Programmed for this Meeting are Symposia, Panel Discussions & Invited Lectures from carefully chosen National & International Experts in addition to an 'Awards Session' for three best Free papers & Posters. An attractive package for delegates & their accompanying persons who would prefer to stay at the Conference Hotel has been outlined in the Brochure.
I am confident that you will stand shoulder to shoulder with ABSI in our Mission to improve the delivery of breast healthcare in India. I am also very hopeful that, as a profession, we will not be prisoners of the past, but architects of the future.
In closing, a traditional warm 'Hyderabad hospitality' awaits you and your accompanying persons. I very much look forward to the participation from many of you at what promises to be an intellectual extravaganza coupled with an 'away from it all' Fellowship & relaxation.
with Best regards
most Sincerely
Dr. P. RaghuRam
ABSICON 2012 Association of Breast Surgeons Of India (ABSI).
European Society of Breast Cancer Specialists (EUSOMA)
EUSOMA
EUSOMA
Patron
Chairman, Organising Committee
Programme Coordinator
Chairmen, Reception Committee
Advisors
Governing Council, ASI
(Andhra Pradesh)
Dr. P. V. Chalapathi RaoPast President, ASI
Dr. P. Raghu Ram
Dr. Hemant Vudayaraju
Dr. R.V. Rao
Dr. D. Raghunadha Rao
Dr. S. Chandrasekhar Rao
Dr. T. Subramanyeswar Rao
Dr. Sai Rajendra
Dr. K V V N Raju
Dr. Suryanarayana Raju
Dr. M.G Nagakishore
Dr. M. Gopichand
Dr. V. Muralikrishna
Dr. Suryasen
Dr. Suresh Chandra Hari
Dr. Madhu Shekhar
Dr. B. Narasaiah
ORGANISING COMMITTEE
Patron
Chairman, Organising Committee
Programme Coordinator
Chairmen, Reception Committee
Advisors
Governing Council, ASI
(Andhra Pradesh)
Dr. P. V. Chalapathi RaoPast President, ASI
Dr. P. Raghu Ram
Dr. Hemant Vudayaraju
Dr. R.V. Rao
Dr. D. Raghunadha Rao
Dr. S. Chandrasekhar Rao
Dr. T. Subramanyeswar Rao
Dr. Sai Rajendra
Dr. K V V N Raju
Dr. Suryanarayana Raju
Dr. M.G Nagakishore
Dr. M. Gopichand
Dr. V. Muralikrishna
Dr. Suryasen
Dr. Suresh Chandra Hari
Dr. Madhu Shekhar
Dr. B. Narasaiah
ORGANISING COMMITTEE
The Association of Breast Surgeons of India (ABSI) was formed in March 2011 as a Section of the Association of Surgeons of India. Our aim is to teach General Surgeons the right management of cancer breast as about 70% of breast cancers are still managed by General Surgeons in rural and semi-urban areas.
To promote this philosophy, ABSI has conducted three zonal meetings-Cuttack in the East, Bengaluru in the South and Pune in the West. ABSI has now planned the First International Congress in May 2012 in Hyderabad jointly with the European Society of Breast Cancer Specialists, with a view to bring state of the art management of breast cancer for the benefit of General Surgeons, Surgical Oncologists and Plastic Surgeons.
I invite you all to join us at Hyderabad from 18th to 20th May, 2012 for this meeting.
Eager to see you in Hyderabad!
Dr. Devendra PatelMS FRCS (Edin.) FRCS (Eng.)
Message from President, ASBI
The Association of Breast Surgeons of India (ABSI) was formed in March 2011 as a Section of the Association of Surgeons of India. Our aim is to teach General Surgeons the right management of cancer breast as about 70% of breast cancers are still managed by General Surgeons in rural and semi-urban areas.
To promote this philosophy, ABSI has conducted three zonal meetings-Cuttack in the East, Bengaluru in the South and Pune in the West. ABSI has now planned the First International Congress in May 2012 in Hyderabad jointly with the European Society of Breast Cancer Specialists, with a view to bring state of the art management of breast cancer for the benefit of General Surgeons, Surgical Oncologists and Plastic Surgeons.
I invite you all to join us at Hyderabad from 18th to 20th May, 2012 for this meeting.
Eager to see you in Hyderabad!
Dr. Devendra PatelMS FRCS (Edin.) FRCS (Eng.)
Message from President, ASBI
Patron
Chairman, Organising Committee
Programme Coordinator
Chairmen, Reception Committee
Advisors
Governing Council, ASI
(Andhra Pradesh)
Dr. P. V. Chalapathi RaoPast President, ASI
Dr. P. Raghu Ram
Dr. Hemant Vudayaraju
Dr. R.V. Rao
Dr. D. Raghunadha Rao
Dr. S. Chandrasekhar Rao
Dr. T. Subramanyeswar Rao
Dr. Sai Rajendra
Dr. K V V N Raju
Dr. Suryanarayana Raju
Dr. M.G Nagakishore
Dr. M. Gopichand
Dr. V. Muralikrishna
Dr. Suryasen
Dr. Suresh Chandra Hari
Dr. Madhu Shekhar
Dr. B. Narasaiah
International Congress - ABSI in association with EUSOMA – First Annual Conference
'How I do it' & 'Meet the Professor' Sessions
Prof. Devendra Patel Oration by Professor Laszlo Tabar, Professor of Radiology, University of Uppsala School of Medicine,
Sweden – 'A new era in the diagnosis & management of Breast cancer'
Award Session
Best Free Paper Presentation
10,000First Prize
5,000Second Prize
3,000Third Prize
Best Poster Presentation
10,000First Prize
5,000Second Prize
3,000Third Prize
Symposia, Panel Discussions & Invited Lectures by eminent National & International experts (All Sessions including Oration will be rated by Delegates)
Electronic voting pads would be made available to all delegates to facilitate interactive Discussion after every Session
HYDERABAD STATEMENT to be released at the end of Conference
Guaranteed 'away from it all' Fellowship & relaxation
Category Early birdBefore 27 Feb
Regular28 Feb-2 April
Late3 April onwards
4,000Delegate 4500 5,000
3,000Accompanying person 3500 4,000
3,000Trainee 3500 4,000
Children < 5 years
3,000Children 5-11 years 3500 4,000
No Registration Fee
Category Early birdBefore 27 Feb
Regular28 Feb-2 April
Late3 April onwards
US$ 200Delegate US$ 250 US$ 300
US$ 100Accompanying person US$ 150 US$ 200
US$ 150Trainee US$ 200 US$ 250
Children < 5 years
US$ 100Children 5-11 years US$ 150 US$ 200
No Registration Fee
Demand Draft along with completed Registration / Abstract / Accommodation Forms must be sent to the Conference Secretariat
Payment in Demand Draft only in favour of ‘ABSICON 2012’ payable in Hyderabad
Postgraduate Students / Trainees must enclose a letter from Head of Department along with Registration Form
International Congress - ABSI in association with EUSOMA – First Annual Conference
'How I do it' & 'Meet the Professor' Sessions
Prof. Devendra Patel Oration by Professor Laszlo Tabar, Professor of Radiology, University of Uppsala School of Medicine,
Sweden – 'A new era in the diagnosis & management of Breast cancer'
Award Session
Best Free Paper Presentation
10,000First Prize
5,000Second Prize
3,000Third Prize
Best Poster Presentation
10,000First Prize
5,000Second Prize
3,000Third Prize
Symposia, Panel Discussions & Invited Lectures by eminent National & International experts (All Sessions including Oration will be rated by Delegates)
Electronic voting pads would be made available to all delegates to facilitate interactive Discussion after every Session
HYDERABAD STATEMENT to be released at the end of Conference
Guaranteed 'away from it all' Fellowship & relaxation
Category Early birdBefore 27 Feb
Regular28 Feb-2 April
Late3 April onwards
4,000Delegate 4500 5,000
3,000Accompanying person 3500 4,000
3,000Trainee 3500 4,000
Children < 5 years
3,000Children 5-11 years 3500 4,000
No Registration Fee
Category Early birdBefore 27 Feb
Regular28 Feb-2 April
Late3 April onwards
US$ 200Delegate US$ 250 US$ 300
US$ 100Accompanying person US$ 150 US$ 200
US$ 150Trainee US$ 200 US$ 250
Children < 5 years
US$ 100Children 5-11 years US$ 150 US$ 200
No Registration Fee
Demand Draft along with completed Registration / Abstract / Accommodation Forms must be sent to the Conference Secretariat
Payment in Demand Draft only in favour of ‘ABSICON 2012’ payable in Hyderabad
Postgraduate Students / Trainees must enclose a letter from Head of Department along with Registration Form
Delegate (Single Occupancy) Two Nights
Before 27 Feb 28 Feb-2 April 3 April onwards
Delegate (On twin sharing basis) Two Nights
Accompanying person (Adult)*** Two Nights 4,000
Children (Under 5 years)No Fee*
Three/Two Nights __ __ __
Children 5 - 11 years** Two Nights
Overseas Delegate (Single Occupancy)
Two Nights US$ 450 US$ 500 US$ 550
Accompanying personOverseas Delegate***
Two Nights US$ 200 US$ 250 US$ 300
Overseas Delegate - Trainee Two Nights US$ 400 US$ 450 US$ 500
This Package includes
Conference Registration fee
Two nights accommodation in Hotel Hyderabad Marriott including breakfast
Three Lunches & two Dinners(PLEASE NOTE: CHECK IN AND CHECK OUT TIME IS 12 NOON)
Notes: Children under 5 yrs will share Double room with parents in Hotel Hyderabad Marriott. An additional bed WILL NOT
be provided in the room. The child will have to share the double bed with parents.
Child will be sharing a Double room in Hotel Hyderabad Marriott with parents. An additional bed will be provided in the room (Subject to availability)
Accompanying person will be sharing a Double room in Hotel Hyderabad Marriott with a registered Delegate.
*
**
***
5,000 6,000
10,000 11,000 12,000
15,000 16,000 17,000
4,000 5,000 6,000
Delegate (Single Occupancy) Two Nights
Before 27 Feb 28 Feb-2 April 3 April onwards
Delegate (On twin sharing basis) Two Nights
Accompanying person (Adult)*** Two Nights 4,000
Children (Under 5 years)No Fee*
Three/Two Nights __ __ __
Children 5 - 11 years** Two Nights
Overseas Delegate (Single Occupancy)
Two Nights US$ 450 US$ 500 US$ 550
Accompanying personOverseas Delegate***
Two Nights US$ 200 US$ 250 US$ 300
Overseas Delegate - Trainee Two Nights US$ 400 US$ 450 US$ 500
This Package includes
Conference Registration fee
Two nights accommodation in Hotel Hyderabad Marriott including breakfast
Three Lunches & two Dinners(PLEASE NOTE: CHECK IN AND CHECK OUT TIME IS 12 NOON)
Notes: Children under 5 yrs will share Double room with parents in Hotel Hyderabad Marriott. An additional bed WILL NOT
be provided in the room. The child will have to share the double bed with parents.
Child will be sharing a Double room in Hotel Hyderabad Marriott with parents. An additional bed will be provided in the room (Subject to availability)
Accompanying person will be sharing a Double room in Hotel Hyderabad Marriott with a registered Delegate.
*
**
***
5,000 6,000
10,000 11,000 12,000
15,000 16,000 17,000
4,000 5,000 6,000
SOME HOTELS IN HYDERABAD (Within 30 minutes driving distance to Conference Venue)
RESERVATIONS MAY BE MADE DIRECTLY
WITH THE HOTEL
Category A- Five Star Hotels (Tax:10.15%)
Hotel / Tariff Single Occupancy Double Room Contact Numbers Email
ITC Kakatiya
Taj Deccan
14000
11000
15500
11500
040 23400132
040 6652 3939
Category B - Four Star Hotels ( Tax:10.15%)
Green Park
Hotel Golconda
5500 6500 040 66515151
5000 5500 040 66110101
Category C – Three Star Hotels( Tax: 10.15%)
3500 4000 040 39884422
Katriya Hotel &Tower
3000 3500 040 23325678
Central Court
Peppermint
3895 4395 040 23232323
3000 3500 040 44351234
Fortune Select Manohar
-
-
SOME HOTELS IN HYDERABAD (Within 30 minutes driving distance to Conference Venue)
RESERVATIONS MAY BE MADE DIRECTLY
WITH THE HOTEL
Category A- Five Star Hotels (Tax:10.15%)
Hotel / Tariff Single Occupancy Double Room Contact Numbers Email
ITC Kakatiya
Taj Deccan
14000
11000
15500
11500
040 23400132
040 6652 3939
Category B - Four Star Hotels ( Tax:10.15%)
Green Park
Hotel Golconda
5500 6500 040 66515151
5000 5500 040 66110101
Category C – Three Star Hotels( Tax: 10.15%)
3500 4000 040 39884422
Katriya Hotel &Tower
3000 3500 040 23325678
Central Court
Peppermint
3895 4395 040 23232323
3000 3500 040 44351234
Fortune Select Manohar
-
-
The Charminar is situated in the southern sector of Hyderabad city and south of the Musi river in the center of the erstwhile walled city. The walls do not exist any more, barring ruins and small stretches at a few palaces. It was declared a protected monument in 1886. This eloquent structure is the most important landmark of the city.
The Golconda Fort is situated in the western sector of Hyderabad city, about 8.5 kms from the Hussain Sagar Lake. Originally known as Mankal, Golconda was built on a hill in 1143. It was a mud fort under the control of the Rajah of Warangal. Later this fort was strengthened and enlarged during the 14th and 17th centuries by the Bahmani Sultans and the Qutub Shahi dynasty. Golconda was the capital of the Qutub Shahi kings. The inner fort has ruins of palaces, mosques, a hill top pavilion rising about 130 meters high from the surroundings and several other public buildings.
Dr. C Narayana Reddys words aptly illustrate the charm that the Hussain Sagar holds. The truth of his statement can be understood only by taking a stroll across the Tank Bund on a pleasant evening. Cool drifts smoothly caress your temples welcoming you to the place. Thirty-three elegant statues of eminent historic personalities.
Ramoji Film City, owned by entrepreneur-cum-film producer Ramoji Rao, is magnificently built across 2,000 acres of land. Right at the entrance you will find two three-star hotels called Tara and Sitara,
where you will be given a royal treatment as a visitor. The splendid looking place is famous for its sets and can make your day with the resplendent things on offer. Hawa Mahal, along the lines of the Golconda Fort, is on a hilltop from where you canc have a bird's eye view of the whole place. RFC has carved a niche for itself with its Japanese garden, the ETV planet ( A multi-purpose editing suit), a multi-purpose building, a pool and artificial waterfalls.
Charminar
Hussain Sagar
Note: For further details on tourism in Hyderabad and Andhra Pradesh Please log on to www.aptourism.in
Golconda
Ramoji Film City
Places of visit
The Charminar is situated in the southern sector of Hyderabad city and south of the Musi river in the center of the erstwhile walled city. The walls do not exist any more, barring ruins and small stretches at a few palaces. It was declared a protected monument in 1886. This eloquent structure is the most important landmark of the city.
The Golconda Fort is situated in the western sector of Hyderabad city, about 8.5 kms from the Hussain Sagar Lake. Originally known as Mankal, Golconda was built on a hill in 1143. It was a mud fort under the control of the Rajah of Warangal. Later this fort was strengthened and enlarged during the 14th and 17th centuries by the Bahmani Sultans and the Qutub Shahi dynasty. Golconda was the capital of the Qutub Shahi kings. The inner fort has ruins of palaces, mosques, a hill top pavilion rising about 130 meters high from the surroundings and several other public buildings.
Dr. C Narayana Reddys words aptly illustrate the charm that the Hussain Sagar holds. The truth of his statement can be understood only by taking a stroll across the Tank Bund on a pleasant evening. Cool drifts smoothly caress your temples welcoming you to the place. Thirty-three elegant statues of eminent historic personalities.
Ramoji Film City, owned by entrepreneur-cum-film producer Ramoji Rao, is magnificently built across 2,000 acres of land. Right at the entrance you will find two three-star hotels called Tara and Sitara,
where you will be given a royal treatment as a visitor. The splendid looking place is famous for its sets and can make your day with the resplendent things on offer. Hawa Mahal, along the lines of the Golconda Fort, is on a hilltop from where you canc have a bird's eye view of the whole place. RFC has carved a niche for itself with its Japanese garden, the ETV planet ( A multi-purpose editing suit), a multi-purpose building, a pool and artificial waterfalls.
Charminar
Hussain Sagar
Note: For further details on tourism in Hyderabad and Andhra Pradesh Please log on to www.aptourism.in
Golconda
Ramoji Film City
Places of visit
ABSICON 2012Registration Form
Institute:
1. Participation information
Title (Prefix): Prof Dr. Mr. Ms.
Name:
Department:
Office: Res:
(As per to appear in the badges)
Mailing Address:
City:
Zip Code:
Country:
Tel:
Fax: Mobile:
Email:
ABSI Member
Non Member Trainee
Accompanying Person (S)
Name:
Mode of Payment
Demand Draft Total Amount Drawn at Dated
Date: Signature
Please send the Registration form by post to Conference Secretariat
Dr. P. Raghu Ram
Chairman, Organizing Committee, ABSICON 2012,
Director, KIMS-USHALAKSHMI Centre for Breast Diseases, Krishna Institute of Medical Sciences, Minister Road,
Begumpet, Hyderabad-500 003. Email: [email protected]
Registration Form
Payable in Hyderabad
ABSICON 2012Registration Form
Institute:
1. Participation information
Title (Prefix): Prof Dr. Mr. Ms.
Name:
Department:
Office: Res:
(As per to appear in the badges)
Mailing Address:
City:
Zip Code:
Country:
Tel:
Fax: Mobile:
Email:
ABSI Member
Non Member Trainee
Accompanying Person (S)
Name:
Mode of Payment
Demand Draft Total Amount Drawn at Dated
Date: Signature
Please send the Registration form by post to Conference Secretariat
Dr. P. Raghu Ram
Chairman, Organizing Committee, ABSICON 2012,
Director, KIMS-USHALAKSHMI Centre for Breast Diseases, Krishna Institute of Medical Sciences, Minister Road,
Begumpet, Hyderabad-500 003. Email: [email protected]
Registration Form
Payable in Hyderabad
1014
ABSICON 2012Accommodation Form
Name:
Mailing Address:
City State Country Pin
Telephone: (O) (R)
(M) (Fax)
Email:
Package: (Hotel, Hyderabad Marriott) – Please tick the appropriate box
Includes Registration + Accommodation at Hotel Hyderabad Marriott
Indian Delegate Overseas Delegate
Delegate Two Nights
Accompanying Person Two Nights
Payment Details: Demand Draft only in favor of ABSICON 2012 payable at Hyderabad.
D.D. No: Total Amount
Drawn at (Bank): Date:
Date: Signature
Please send the Accommodation form by post to Conference SecretariatDr. P. Raghu Ram
Chairman, Organizing Committee, ABSICON 2012, Director, KIMS-USHALAKSHMI Centre for Breast Diseases,
Krishna Institute of Medical Sciences, Minister Road, Begumpet, Hyderabad-500 003. Email: [email protected]
Accommodation Form
11
ABSICON 2012Accommodation Form
Name:
Mailing Address:
City State Country Pin
Telephone: (O) (R)
(M) (Fax)
Email:
Package: (Hotel, Hyderabad Marriott) – Please tick the appropriate box
Includes Registration + Accommodation at Hotel Hyderabad Marriott
Indian Delegate Overseas Delegate
Delegate Two Nights
Accompanying Person Two Nights
Payment Details: Demand Draft only in favor of ABSICON 2012 payable at Hyderabad.
D.D. No: Total Amount
Drawn at (Bank): Date:
Date: Signature
Please send the Accommodation form by post to Conference SecretariatDr. P. Raghu Ram
Chairman, Organizing Committee, ABSICON 2012, Director, KIMS-USHALAKSHMI Centre for Breast Diseases,
Krishna Institute of Medical Sciences, Minister Road, Begumpet, Hyderabad-500 003. Email: [email protected]
Accommodation Form
11
1212
13
Abstract Regulations
With the submission of an abstract to ABSICON 2012, the first author (Presenting author):
v Must register for the Conference.
v Accepts responsibility for the accuracy of the submitted abstract.
v Confirms that all authors are aware of and agree to the content of the abstract and the data presented.
v Warrants that the data and conclusions presented in the abstract have not been published in the same format and with the same title prior to the date of the conference.
v Gives permission for the abstract, when selected for presentation (Oral or Poster), to be published. Submitted abstracts cannot be withdrawn after Monday 27th February 2012.
Abstract Format
t In order to be considered, abstract should respect the following guidelines:
t The abstract must be submitted in good English. The Scientific Committee reserves the right to reject those abstracts which are presented in poor English.
t The title of the abstract should be brief and reflect the content of the abstract.
t Not more than 5 authors can be listed. Only institutional affiliations, cities and countries should follow,
t Abstracts should be structured in such a way as to include:
1. Aims
2. Methods
3. Results
4. Conclusion
Abstract selection processThe Scientific Committee will make the selection of abstracts for oral and poster presentations in March 2012. If a selected author cannot attend, the presenting author should assign a replacement.
General instructions for abstract submissionAbstracts should be submitted by post to Conference Secretariat
Dr. P. Raghu RamChairman, Organizing Committee,
Director, KIMS-USHALAKSHMI Centre for Breast Diseases, Krishna Institute of Medical Sciences, Minister Road, Begumpet, Hyderabad-500 003. Email: [email protected]
Abstracts
13
Abstract Regulations
With the submission of an abstract to ABSICON 2012, the first author (Presenting author):
v Must register for the Conference.
v Accepts responsibility for the accuracy of the submitted abstract.
v Confirms that all authors are aware of and agree to the content of the abstract and the data presented.
v Warrants that the data and conclusions presented in the abstract have not been published in the same format and with the same title prior to the date of the conference.
v Gives permission for the abstract, when selected for presentation (Oral or Poster), to be published. Submitted abstracts cannot be withdrawn after Monday 27th February 2012.
Abstract Format
t In order to be considered, abstract should respect the following guidelines:
t The abstract must be submitted in good English. The Scientific Committee reserves the right to reject those abstracts which are presented in poor English.
t The title of the abstract should be brief and reflect the content of the abstract.
t Not more than 5 authors can be listed. Only institutional affiliations, cities and countries should follow,
t Abstracts should be structured in such a way as to include:
1. Aims
2. Methods
3. Results
4. Conclusion
Abstract selection processThe Scientific Committee will make the selection of abstracts for oral and poster presentations in March 2012. If a selected author cannot attend, the presenting author should assign a replacement.
General instructions for abstract submissionAbstracts should be submitted by post to Conference Secretariat
Dr. P. Raghu RamChairman, Organizing Committee,
Director, KIMS-USHALAKSHMI Centre for Breast Diseases, Krishna Institute of Medical Sciences, Minister Road, Begumpet, Hyderabad-500 003. Email: [email protected]
Abstracts
Abstract Submission Form
ABSICON 2012Abstract Submission Form
Presentation: Oral
Presenting author (Please fill a capital letters)
Name:
Department/institution
Mailing Address:
City State Country Pin
Telephone Fax
Mobile
Please send the Abstract Submission Form along with the Abstract Form by post to the Conference Secretariat
Dr. P. Raghu RamChairman, Organizing Committee, Director, KIMS-USHALAKSHMI Centre for Breast Diseases,
Krishna Institute of Medical Sciences, Minister Road, Begumpet, Hyderabad-500 003.Email: [email protected]
Deadline for Receiving Abstracts Monday 12th March 2012
Poster
15
Abstract Submission Form
ABSICON 2012Abstract Submission Form
Presentation: Oral
Presenting author (Please fill a capital letters)
Name:
Department/institution
Mailing Address:
City State Country Pin
Telephone Fax
Mobile
Please send the Abstract Submission Form along with the Abstract Form by post to the Conference Secretariat
Dr. P. Raghu RamChairman, Organizing Committee, Director, KIMS-USHALAKSHMI Centre for Breast Diseases,
Krishna Institute of Medical Sciences, Minister Road, Begumpet, Hyderabad-500 003.Email: [email protected]
Deadline for Receiving Abstracts Monday 12th March 2012
Poster
15
1616
Abstract
ABSICON 2012
Presentation: Oral Poster
Abstract title
Authors (Please underline the Presenting Author):
Institution/ Hospital:
(Please submit a clearly printed abstract under the following headings:
Aims, Methods, Results, Conclusion in Double spacing, using times new Roman font 12.
Abstract should not be more than 250 words)
17
Abstract
ABSICON 2012
Presentation: Oral Poster
Abstract title
Authors (Please underline the Presenting Author):
Institution/ Hospital:
(Please submit a clearly printed abstract under the following headings:
Aims, Methods, Results, Conclusion in Double spacing, using times new Roman font 12.
Abstract should not be more than 250 words)
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1818
Basic Information
Professional Information Residential Address
MBBS
Post Graduation
Super Speciality
Name : ............................................................................................................................................................................
Surname : .............................................................................................................................................................................
Date of Birth : .............................................................................................................................................................................
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MEMBERSHIP FORM
The Association ofBreast Surgeons of India
ABSIwww.absi.in
Photo required for preparing
Membership card
19
Basic Information
Professional Information Residential Address
MBBS
Post Graduation
Super Speciality
Name : ............................................................................................................................................................................
Surname : .............................................................................................................................................................................
Date of Birth : .............................................................................................................................................................................
Degree : .............................................................................................................................................................................
E-Mail : .............................................................................................................................................................................
Institution : ................................................................................. .....................................................................................
Department : ................................................................................. .....................................................................................
Address : ................................................................................. .....................................................................................
................................................................................. .....................................................................................
City : ................................................................................. .....................................................................................
State : ................................................................................. .....................................................................................
Pincode : ................................................................................. .....................................................................................
Phone : ................................................................................. .....................................................................................
Fax : ................................................................................. .....................................................................................
Education : ................................................................................. .....................................................................................
College : ...........................................................................................................................................................................
University : ...........................................................................................................................................................................
Year of Passing : ...........................................................................................................................................................................
College : ...........................................................................................................................................................................
University :............................................................................................................................................................................
Year of Passing : ...........................................................................................................................................................................
College : ...........................................................................................................................................................................
University : ...........................................................................................................................................................................
Year of Passing : ...........................................................................................................................................................................
MEMBERSHIP FORM
The Association ofBreast Surgeons of India
ABSIwww.absi.in
Photo required for preparing
Membership card
19
Registration Number …………………….......……………………State ..............................................................................................
ASI Registration Number ………………………..........………………State ........................................................................................
Whether a member of any other International Organisations IASO / OTHERS (Please Mention)
Life member: General Surgeons, Surgical Oncologists & Plastic Surgeons who are Life members of ASI
Associate Member: Trainees in General Surgery, Surgical Oncology & Plastic Surgery
Overseas Member: General Surgeons, Surgical Oncologists & Plastic Surgeons living overseas
Affiliate Member: Gynecologists, General Practitioners, Radiologists, Pathologists, Medical Oncologists, Radiation Oncologists, Breast Care Nurses, Palliative care Physicians & Breast cancer
Membership fee: None (complimentary until March 2012)
DD in favour of Association of Breast Surgeons of India Payable in Hyderabad
Signature
Signature
Signature
Received Date : …………………………………. Receipt sent on : ...................................................................................................
Medical Council Registration
CATEGORY OF MEMBERSHIP
Dr. P. Raghu Ram
Whether an active member of ASI : Yes / No
Membership fee: Rs. 2000/-
Membership fee: Rs. 1500/-
Membership fee: $ 300/-
advocacy groups
Demand Draft Details
Demand Draft No :
Bank :
Date :
Place :
Proposed by:
ASI Life Membership No:
Seconded by:
ASI Life Membership No:
Contact Details
MS, FRCS (Eng), FRCS (Edin), FRCS (Glasg), FRCS (Irel)
Hon. Secretary, ABSIKIMS-USHALAKSHMI Centre for Breast DiseasesKrishna Institute of Medical Sciences Ltd.1-8-31/1, Minister Road, Secunderabad - 500 003.Andhra Pradesh, India.Tel: 040 - 4488 5190 / 4488 5191e-mail: [email protected]
For Office Use
Membership No :
20
Registration Number …………………….......……………………State ..............................................................................................
ASI Registration Number ………………………..........………………State ........................................................................................
Whether a member of any other International Organisations IASO / OTHERS (Please Mention)
Life member: General Surgeons, Surgical Oncologists & Plastic Surgeons who are Life members of ASI
Associate Member: Trainees in General Surgery, Surgical Oncology & Plastic Surgery
Overseas Member: General Surgeons, Surgical Oncologists & Plastic Surgeons living overseas
Affiliate Member: Gynecologists, General Practitioners, Radiologists, Pathologists, Medical Oncologists, Radiation Oncologists, Breast Care Nurses, Palliative care Physicians & Breast cancer
Membership fee: None (complimentary until March 2012)
DD in favour of Association of Breast Surgeons of India Payable in Hyderabad
Signature
Signature
Signature
Received Date : …………………………………. Receipt sent on : ...................................................................................................
Medical Council Registration
CATEGORY OF MEMBERSHIP
Dr. P. Raghu Ram
Whether an active member of ASI : Yes / No
Membership fee: Rs. 2000/-
Membership fee: Rs. 1500/-
Membership fee: $ 300/-
advocacy groups
Demand Draft Details
Demand Draft No :
Bank :
Date :
Place :
Proposed by:
ASI Life Membership No:
Seconded by:
ASI Life Membership No:
Contact Details
MS, FRCS (Eng), FRCS (Edin), FRCS (Glasg), FRCS (Irel)
Hon. Secretary, ABSIKIMS-USHALAKSHMI Centre for Breast DiseasesKrishna Institute of Medical Sciences Ltd.1-8-31/1, Minister Road, Secunderabad - 500 003.Andhra Pradesh, India.Tel: 040 - 4488 5190 / 4488 5191e-mail: [email protected]
For Office Use
Membership No :
20
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