{"id":7538,"date":"2022-10-31T10:06:24","date_gmt":"2022-10-31T10:06:24","guid":{"rendered":"https:\/\/tmckolkata.com\/in\/events\/track2023-registration-pgt-copy\/"},"modified":"2022-10-31T10:15:50","modified_gmt":"2022-10-31T10:15:50","slug":"ttask2022-registration-pgt","status":"publish","type":"page","link":"https:\/\/tmckolkata.com\/in\/events\/ttask2022-registration-pgt\/","title":{"rendered":"TTASK 2022 &#8211; Registration PGT"},"content":{"rendered":"<div id='av-layout-grid-1'  class='av-layout-grid-container av-3znmz6-f261ea6a19a67a36367cd24bf4acbbb7 entry-content-wrapper main_color av-fixed-cells  avia-builder-el-0  el_before_av_heading  avia-builder-el-first   container_wrap sidebar_right'  >\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-3tm3yi-4273f6655070a95f49a22f9491ac6608\">\n.flex_cell.av-3tm3yi-4273f6655070a95f49a22f9491ac6608{\nvertical-align:middle;\nbackground:url(https:\/\/tmckolkata.com\/in\/wp-content\/uploads\/2021\/06\/event_header-300x56.jpg) 50% 50% no-repeat scroll #c1c1c1;\n}\n.responsive #top #wrap_all .flex_cell.av-3tm3yi-4273f6655070a95f49a22f9491ac6608{\npadding:100px 100px 100px 100px !important;\n}\n<\/style>\n<div class='flex_cell av-3tm3yi-4273f6655070a95f49a22f9491ac6608 av-gridrow-cell av_one_full no_margin  avia-builder-el-1  avia-builder-el-no-sibling  content-align-middle avia-full-stretch'  ><div class='flex_cell_inner'><\/div><\/div>\n<\/div><div id='after_grid_row_1'  class='main_color av_default_container_wrap container_wrap sidebar_right'  ><div class='container av-section-cont-open' ><div class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-7538'><div class='entry-content-wrapper clearfix'>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-l2fn2wa1-3fe7b29f7806eaf5b50a4411ff8e5da1\">\n#top .av-special-heading.av-l2fn2wa1-3fe7b29f7806eaf5b50a4411ff8e5da1{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-l2fn2wa1-3fe7b29f7806eaf5b50a4411ff8e5da1 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-l2fn2wa1-3fe7b29f7806eaf5b50a4411ff8e5da1 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-l2fn2wa1-3fe7b29f7806eaf5b50a4411ff8e5da1 av-special-heading-h3 blockquote modern-quote  avia-builder-el-2  el_after_av_layout_row  el_before_av_one_half  avia-builder-el-first '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Tata medical center Thoracic Anaesthesia Symposium, Kolkata 2022<\/h3><div class='av-subheading av-subheading_below'><p>Choose either NEFT or CARD option for payment (Rs. 1500)<\/p>\n<\/div><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-3lsepqy-dcc1952921c15de1c63d81c148aefe54\">\n.flex_column.av-3lsepqy-dcc1952921c15de1c63d81c148aefe54{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-3lsepqy-dcc1952921c15de1c63d81c148aefe54 av_one_half  avia-builder-el-3  el_after_av_heading  el_before_av_one_half  first flex_column_div av-zero-column-padding  '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-14ghgi-3d5431d8a52a7b6947a510ccc422cd28\">\n#top .av-special-heading.av-14ghgi-3d5431d8a52a7b6947a510ccc422cd28{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-14ghgi-3d5431d8a52a7b6947a510ccc422cd28 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-14ghgi-3d5431d8a52a7b6947a510ccc422cd28 .av-subheading{\nfont-size:16px;\n}\n<\/style>\n<div  class='av-special-heading av-14ghgi-3d5431d8a52a7b6947a510ccc422cd28 av-special-heading-h1 blockquote modern-quote  avia-builder-el-4  el_before_av_contact  avia-builder-el-first '><h1 class='av-special-heading-tag '  itemprop=\"headline\"  >Registration Form<\/h1><div class='av-subheading av-subheading_below'><p>WITH <strong>NEFT <\/strong>PAYMENT OPTION<\/p>\n<\/div><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<form action=\"https:\/\/tmckolkata.com\/in\/events\/ttask2022-registration-pgt\/\" method=\"post\" data-fields-with-error=\"Found errors in the following field(s):\" class=\"avia_ajax_form av-form-labels-visible   avia-builder-el-5  el_after_av_heading  el_before_av_heading   \" data-avia-form-id=\"1\" data-avia-redirect='' ><fieldset><p class='  first_form  form_element form_fullwidth' id='element_avia_1_1'><label for=\"avia_1_1\">Name : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_1_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_1_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_2_1'><label for=\"avia_2_1\">Gender : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_2_1\" class=\"select is_empty\" id=\"avia_2_1\"><option   value='Male'>Male<\/option><option   value='Female'>Female<\/option><option   value='Prefer not to mention'>Prefer not to mention<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_3_1'><label for=\"avia_3_1\">Address : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_3_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_3_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_4_1'><label for=\"avia_4_1\">Mobile Number : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_4_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_4_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_5_1'><label for=\"avia_5_1\">Email : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_5_1\" class=\"text_input is_email\" type=\"text\" id=\"avia_5_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_6_1'><label for=\"avia_6_1\">Current Description of Work :<\/label><select  name=\"avia_6_1\" class=\"select \" id=\"avia_6_1\"><option   value='PG student'>PG student<\/option><option   value='Practitioner teaching'>Practitioner teaching<\/option><option   value='Practitioner non-teaching'>Practitioner non-teaching<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_7_1'><label for=\"avia_7_1\">Place of Work (Name of Hospital\/Institution) : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_7_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_7_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_8_1'><label for=\"avia_8_1\">Food Preference :<\/label><select  name=\"avia_8_1\" class=\"select \" id=\"avia_8_1\"><option   value='Veg'>Veg<\/option><option   value='Non-Veg'>Non-Veg<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_9_1'><label for=\"avia_9_1\">Mode of Payment : (Amount Rs. 3000)<\/label><select  name=\"avia_9_1\" class=\"select \" id=\"avia_9_1\"><option   value='NEFT'>NEFT<\/option><option   value='Cheque'>Cheque<\/option><option   value='Draft'>Draft<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_10_1'><label for=\"avia_10_1\">NEFT \/ Cheque \/ Draft Reference<\/label> <input name=\"avia_10_1\" class=\"text_input \" type=\"text\" id=\"avia_10_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_11_1'><label for=\"avia_11_1\">NEFT \/ Cheque \/ Draft Date<\/label> <input name=\"avia_11_1\" class=\"text_input \" type=\"text\" id=\"avia_11_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_12_1'><label for=\"avia_12_1\">NEFT \/ Cheque \/ Draft Amount<\/label> <input name=\"avia_12_1\" class=\"text_input \" type=\"text\" id=\"avia_12_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_13_1'><label for=\"avia_13_1\" class=\"textare_label hidden textare_label_avia_13_1\">Any other information<\/label><textarea  name=\"avia_13_1\" class=\"text_area \" cols=\"40\" rows=\"7\" id=\"avia_13_1\" ><\/textarea><\/p><p class=\"hidden\"><input type=\"text\" name=\"avia_14_1\" class=\"hidden \" id=\"avia_14_1\" value=\"\" \/><\/p><div id='avia_15_1' class='av-recaptcha-area  first_form  form_element form_fullwidth '  data-container_class=\"\" data-custom_class=\"\" data-context=\"av_contact_form\" data-token_input=\"av_recaptcha_token\" data-version=\"avia_recaptcha_v3\" data-theme=\"light\" data-size=\"normal\" data-score=\"0.5\" data-text_to_preview=\"\" data-value=\"\"><div class=\"av-google-badge-message hidden\">This site is protected by reCAPTCHA and the Google <a href=\"https:\/\/policies.google.com\/privacy\" target=\"_blank\" rel=\"noopener noreferrer\">Privacy Policy<\/a> and <a href=\"https:\/\/policies.google.com\/terms\" target=\"_blank\" rel=\"noopener noreferrer\">Terms of Service<\/a> apply.<\/div><\/div><p class=\"form_element \"><input type=\"hidden\" value=\"1\" name=\"avia_generated_form1\" \/><input type=\"submit\" value=\"Submit\" class=\"button\"  data-sending-label=\"Sending\"\/><\/p><\/fieldset><div class=\"avia-disabled-form\">This contact form is deactivated because you refused to accept Google reCaptcha service which is necessary to validate any messages sent by the form.<\/div><\/form><div id=\"ajaxresponse_1\" class=\"ajaxresponse ajaxresponse_1 hidden\"><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-2haghu-faf5cb9f2ccae959f81f360ced04ce31\">\n#top .av-special-heading.av-2haghu-faf5cb9f2ccae959f81f360ced04ce31{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-2haghu-faf5cb9f2ccae959f81f360ced04ce31 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-2haghu-faf5cb9f2ccae959f81f360ced04ce31 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-2haghu-faf5cb9f2ccae959f81f360ced04ce31 av-special-heading-h3  avia-builder-el-6  el_after_av_contact  el_before_av_textblock '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Bank Detail for Offline Payment<\/h3><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-jt2kkpc0-f6e7f84301a801dfe5f8c7bea76939b7 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p style=\"text-align: justify;\"><strong>Hospital Name:<\/strong> Tata Medical Center<br \/>\n<strong>Payee \/ Cheque Name:<\/strong> Tata Medical Centre Trust<br \/>\n<strong>Hospital Address:<\/strong> 14 Major Arterial Road (EW), New Town, Rajarhat, Kolkata-700160<br \/>\n<strong>Bank Name:<\/strong> HDFC Bank Limited<br \/>\n<strong>Bank Account Number:<\/strong> 00601-6600-00021<br \/>\n<strong>Bank Account Type:<\/strong> Savings Account<br \/>\n<strong>Bank Branch:<\/strong> Fort Mumbai<br \/>\n<strong>Bank Address:<\/strong> Fort Mumbai, Manekji Wadia Building, Groung Floor, Nanik Motwani Marg, Mumbai &#8211; 400001<br \/>\n<strong>IFSC :<\/strong> HDFC0000060<\/p>\n<\/div><\/section><\/p><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-q4s5h6-ac37dcc1d36ceea9e9533f10e8187bed\">\n.flex_column.av-q4s5h6-ac37dcc1d36ceea9e9533f10e8187bed{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-q4s5h6-ac37dcc1d36ceea9e9533f10e8187bed av_one_half  avia-builder-el-8  el_after_av_one_half  el_before_av_layout_row  avia-builder-el-last  flex_column_div av-zero-column-padding  '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-2kpwxu-7c1505aee6abd48dd1d2a59e218db49b\">\n#top .av-special-heading.av-2kpwxu-7c1505aee6abd48dd1d2a59e218db49b{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-2kpwxu-7c1505aee6abd48dd1d2a59e218db49b .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-2kpwxu-7c1505aee6abd48dd1d2a59e218db49b .av-subheading{\nfont-size:17px;\n}\n<\/style>\n<div  class='av-special-heading av-2kpwxu-7c1505aee6abd48dd1d2a59e218db49b av-special-heading-h1 blockquote modern-quote  avia-builder-el-9  el_before_av_contact  avia-builder-el-first '><h1 class='av-special-heading-tag '  itemprop=\"headline\"  >Registration Form<\/h1><div class='av-subheading av-subheading_below'><p>WITH <strong>CARD <\/strong>PAYMENT OPTION<\/p>\n<\/div><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<form action=\"https:\/\/tmckolkata.com\/in\/events\/ttask2022-registration-pgt\/\" method=\"post\" data-fields-with-error=\"Found errors in the following field(s):\" class=\"avia_ajax_form av-form-labels-visible   avia-builder-el-10  el_after_av_heading  avia-builder-el-last   \" data-avia-form-id=\"2\" data-avia-redirect='https:\/\/www.tmckolkata.com\/apps\/events\/1051' ><fieldset><p class='  first_form  form_element form_fullwidth' id='element_avia_1_2'><label for=\"avia_1_2\">Name : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_1_2\" class=\"text_input is_empty\" type=\"text\" id=\"avia_1_2\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_2_2'><label for=\"avia_2_2\">Gender : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_2_2\" class=\"select is_empty\" id=\"avia_2_2\"><option   value='Male'>Male<\/option><option   value='Female'>Female<\/option><option   value='Prefer not to mention'>Prefer not to mention<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_3_2'><label for=\"avia_3_2\">Address : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_3_2\" class=\"text_input is_empty\" type=\"text\" id=\"avia_3_2\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_4_2'><label for=\"avia_4_2\">Mobile Number : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_4_2\" class=\"text_input is_empty\" type=\"text\" id=\"avia_4_2\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_5_2'><label for=\"avia_5_2\">Email : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_5_2\" class=\"text_input is_email\" type=\"text\" id=\"avia_5_2\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_6_2'><label for=\"avia_6_2\">Current Description of Work :<\/label><select  name=\"avia_6_2\" class=\"select \" id=\"avia_6_2\"><option   value='PG student'>PG student<\/option><option   value='Practitioner teaching'>Practitioner teaching<\/option><option   value='Practitioner non-teaching'>Practitioner non-teaching<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_7_2'><label for=\"avia_7_2\">Place of Work (Name of Hospital\/Institution) : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_7_2\" class=\"text_input is_empty\" type=\"text\" id=\"avia_7_2\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_8_2'><label for=\"avia_8_2\">Food Preference :<\/label><select  name=\"avia_8_2\" class=\"select \" id=\"avia_8_2\"><option   value='Veg'>Veg<\/option><option   value='Non-Veg'>Non-Veg<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_9_2'><label for=\"avia_9_2\">Mode of Payment : (Amount Rs. 1500) <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_9_2\" class=\"select is_empty\" id=\"avia_9_2\"><option   value='CREDIT CARD'>CREDIT CARD<\/option><option   value='DEBIT CARD'>DEBIT CARD<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_10_2'><label for=\"avia_10_2\" class=\"textare_label hidden textare_label_avia_10_2\">Any other information<\/label><textarea  name=\"avia_10_2\" class=\"text_area \" cols=\"40\" rows=\"7\" id=\"avia_10_2\" ><\/textarea><\/p><p class=\"hidden\"><input type=\"text\" name=\"avia_11_2\" class=\"hidden \" id=\"avia_11_2\" value=\"\" \/><\/p><div id='avia_12_2' class='av-recaptcha-area  first_form  form_element form_fullwidth '  data-container_class=\"\" data-custom_class=\"\" data-context=\"av_contact_form\" data-token_input=\"av_recaptcha_token\" data-version=\"avia_recaptcha_v3\" data-theme=\"light\" data-size=\"normal\" data-score=\"0.5\" data-text_to_preview=\"\" data-value=\"\"><div class=\"av-google-badge-message hidden\">This site is protected by reCAPTCHA and the Google <a href=\"https:\/\/policies.google.com\/privacy\" target=\"_blank\" rel=\"noopener noreferrer\">Privacy Policy<\/a> and <a href=\"https:\/\/policies.google.com\/terms\" target=\"_blank\" rel=\"noopener noreferrer\">Terms of Service<\/a> apply.<\/div><\/div><p class=\"form_element \"><input type=\"hidden\" value=\"1\" name=\"avia_generated_form2\" \/><input type=\"submit\" value=\"Submit\" class=\"button\"  data-sending-label=\"Sending\"\/><\/p><\/fieldset><div class=\"avia-disabled-form\">This contact form is deactivated because you refused to accept Google reCaptcha service which is necessary to validate any messages sent by the form.<\/div><\/form><div id=\"ajaxresponse_2\" class=\"ajaxresponse ajaxresponse_2 hidden\"><\/div><\/p><\/div><\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='av-layout-grid-2'  class='av-layout-grid-container av-2jft0b-35fca6f06f34b2d032652cbdb5fcd422 entry-content-wrapper main_color av-flex-cells  avia-builder-el-11  el_after_av_one_half  avia-builder-el-last  grid-row-not-first  container_wrap sidebar_right'  >\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-jsohstnf-a341e83612e197f5825bf744f289da81\">\n.flex_cell.av-jsohstnf-a341e83612e197f5825bf744f289da81{\nvertical-align:top;\nbackground-color:#037cc1;\n}\n.responsive #top #wrap_all .flex_cell.av-jsohstnf-a341e83612e197f5825bf744f289da81{\npadding:15px 15px 15px 15px 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