{"id":9336,"date":"2023-11-30T12:07:28","date_gmt":"2023-11-30T12:07:28","guid":{"rendered":"https:\/\/tmckolkata.com\/in\/events\/rcr-tmc-registration-conference-copy\/"},"modified":"2023-12-01T06:34:05","modified_gmt":"2023-12-01T06:34:05","slug":"rcr-tmc-registration-conference-sbrt","status":"publish","type":"page","link":"https:\/\/tmckolkata.com\/in\/events\/rcr-tmc-registration-conference-sbrt\/","title":{"rendered":"RCR-TMC Registration &#8211; Conference+SBRT"},"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-54128607e6fc1e679b0725819b141277\">\n.flex_cell.av-3tm3yi-54128607e6fc1e679b0725819b141277{\nvertical-align:bottom;\nbackground:url(https:\/\/tmckolkata.com\/in\/wp-content\/uploads\/2023\/05\/common_header.jpg) 0% 0% no-repeat scroll ;\n}\n.responsive #top #wrap_all .flex_cell.av-3tm3yi-54128607e6fc1e679b0725819b141277{\npadding:80px 80px 80px 80px !important;\n}\n<\/style>\n<div class='flex_cell av-3tm3yi-54128607e6fc1e679b0725819b141277 av-gridrow-cell av_one_full no_margin  avia-builder-el-1  avia-builder-el-no-sibling  content-align-bottom 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-9336'><div class='entry-content-wrapper clearfix'>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-l2fn2wa1-1471a85052765facc9c3437be9ef3966\">\n#top .av-special-heading.av-l2fn2wa1-1471a85052765facc9c3437be9ef3966{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-l2fn2wa1-1471a85052765facc9c3437be9ef3966 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-l2fn2wa1-1471a85052765facc9c3437be9ef3966 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-l2fn2wa1-1471a85052765facc9c3437be9ef3966 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\"  >Registration form for the RCR-TMC Conference<\/h3><div class='av-subheading av-subheading_below'><p><strong>Registration fees for Conference + Lung SBRT<\/strong> Choose either NEFT or CARD option for payment (Rs. 12,000)<\/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-shf8y3-885dce3eb7eb983863f3745590516d9a\">\n#top .av-special-heading.av-shf8y3-885dce3eb7eb983863f3745590516d9a{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-shf8y3-885dce3eb7eb983863f3745590516d9a .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-shf8y3-885dce3eb7eb983863f3745590516d9a .av-subheading{\nfont-size:16px;\n}\n<\/style>\n<div  class='av-special-heading av-shf8y3-885dce3eb7eb983863f3745590516d9a 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\/rcr-tmc-registration-conference-sbrt\/\" 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  avia-builder-el-last   \" data-avia-form-id=\"1\" data-avia-redirect='' ><fieldset><div id='avia_1_1' class='av-form-text'><p>\n<strong>Personal Information:<\/strong><\/p>\n<\/div><p class='  first_form  form_element form_fullwidth' id='element_avia_2_1'><label for=\"avia_2_1\">Name : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_2_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_2_1\" value=\"\" \/><\/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\">Country:<\/label> <input name=\"avia_4_1\" class=\"text_input \" type=\"text\" id=\"avia_4_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_element_third' id='element_avia_5_1'><label for=\"avia_5_1\">Mobile Number : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_5_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_5_1\" value=\"\" \/><\/p><p class='  form_element form_element_two_third' id='element_avia_6_1'><label for=\"avia_6_1\">Email : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_6_1\" class=\"text_input is_email\" type=\"text\" id=\"avia_6_1\" value=\"\" \/><\/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) :<\/label> <input name=\"avia_7_1\" class=\"text_input \" 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\">Type of Institution: <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_8_1\" class=\"select is_empty\" id=\"avia_8_1\"><option   value='Government Hospital'>Government Hospital<\/option><option   value='Private or Corporate Hospital'>Private or Corporate Hospital<\/option><option   value='Other'>Other<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_9_1'><label for=\"avia_9_1\">Professional Position:<\/label> <input name=\"avia_9_1\" class=\"text_input \" type=\"text\" id=\"avia_9_1\" value=\"\" \/><\/p><div id='avia_10_1' class='av-form-text'><p>\n<strong>Payment:<\/strong><\/p>\n<\/div><p class='  first_form  form_element form_fullwidth' id='element_avia_11_1'><label for=\"avia_11_1\">Mode of Payment : (Amount Rs. 12,000)<\/label><select  name=\"avia_11_1\" class=\"select \" id=\"avia_11_1\"><option   value='NEFT'>NEFT<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_12_1'><label for=\"avia_12_1\">NEFT \/ Cheque \/ Draft Reference<\/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\">NEFT \/ Cheque \/ Draft Date<\/label> <input name=\"avia_13_1\" class=\"text_input \" type=\"text\" id=\"avia_13_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_14_1'><label for=\"avia_14_1\">NEFT \/ Cheque \/ Draft Amount<\/label> <input name=\"avia_14_1\" class=\"text_input \" type=\"text\" id=\"avia_14_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_15_1'><label for=\"avia_15_1\" class=\"textare_label hidden textare_label_avia_15_1\">Any other information<\/label><textarea  name=\"avia_15_1\" class=\"text_area \" cols=\"40\" rows=\"7\" id=\"avia_15_1\" ><\/textarea><\/p><p class=\"hidden\"><input type=\"text\" name=\"avia_16_1\" class=\"hidden \" id=\"avia_16_1\" value=\"\" \/><\/p><p class='   form_element form_fullwidth' id='element_avia_17_1'><span class='value_verifier_label'>3 + 4 = ?<\/span><input name=\"avia_17_1_verifier\" type=\"hidden\" id=\"avia_17_1_verifier\" value=\"163764843\"\/><label for=\"avia_17_1\">Please prove that you are human by solving the equation <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><input name=\"avia_17_1\" class=\"text_input captcha\" type=\"text\" id=\"avia_17_1\" value=\"\"\/><\/p><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><\/form><div id=\"ajaxresponse_1\" class=\"ajaxresponse ajaxresponse_1 hidden\"><\/div><\/p><\/div><div  class='flex_column av-215oph-a1bda063f0a73bb3fd5a9cabcd7069d1 av_one_half  avia-builder-el-6  el_after_av_one_half  el_before_av_layout_row  avia-builder-el-last  flex_column_div  '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-14ghgi-276d4b6d896bd157f0461a7fcd8cfb7d\">\n#top .av-special-heading.av-14ghgi-276d4b6d896bd157f0461a7fcd8cfb7d{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-14ghgi-276d4b6d896bd157f0461a7fcd8cfb7d .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-14ghgi-276d4b6d896bd157f0461a7fcd8cfb7d .av-subheading{\nfont-size:16px;\n}\n<\/style>\n<div  class='av-special-heading av-14ghgi-276d4b6d896bd157f0461a7fcd8cfb7d av-special-heading-h1 blockquote modern-quote  avia-builder-el-7  el_before_av_contact  avia-builder-el-first  av-linked-heading'><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\/rcr-tmc-registration-conference-sbrt\/\" method=\"post\" data-fields-with-error=\"Found errors in the following field(s):\" class=\"avia_ajax_form av-form-labels-visible   avia-builder-el-8  el_after_av_heading  el_before_av_heading   \" data-avia-form-id=\"2\" data-avia-redirect='https:\/\/www.tmckolkata.com\/apps\/events\/1083' ><fieldset><div id='avia_1_2' class='av-form-text'><p>\n<strong>Personal Information:<\/strong><\/p>\n<\/div><p class='  first_form  form_element form_fullwidth' id='element_avia_2_2'><label for=\"avia_2_2\">Name : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_2_2\" class=\"text_input is_empty\" type=\"text\" id=\"avia_2_2\" value=\"\" \/><\/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\">Country:<\/label> <input name=\"avia_4_2\" class=\"text_input \" type=\"text\" id=\"avia_4_2\" value=\"\" \/><\/p><p class='  first_form  form_element form_element_third' id='element_avia_5_2'><label for=\"avia_5_2\">Mobile Number : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_5_2\" class=\"text_input is_empty\" type=\"text\" id=\"avia_5_2\" value=\"\" \/><\/p><p class='  form_element form_element_two_third' id='element_avia_6_2'><label for=\"avia_6_2\">Email : <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_6_2\" class=\"text_input is_email\" type=\"text\" id=\"avia_6_2\" value=\"\" \/><\/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) :<\/label> <input name=\"avia_7_2\" class=\"text_input \" 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\">Type of Institution: <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_8_2\" class=\"select is_empty\" id=\"avia_8_2\"><option   value='Government Hospital'>Government Hospital<\/option><option   value='Private or Corporate Hospital'>Private or Corporate Hospital<\/option><option   value='Other'>Other<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_9_2'><label for=\"avia_9_2\">Professional Position:<\/label> <input name=\"avia_9_2\" class=\"text_input \" type=\"text\" id=\"avia_9_2\" value=\"\" \/><\/p><div id='avia_10_2' class='av-form-text'><p>\n<strong>Payment:<\/strong><\/p>\n<\/div><p class='  first_form  form_element form_fullwidth' id='element_avia_11_2'><label for=\"avia_11_2\">Mode of Payment : (Amount Rs. 12,000)<\/label><select  name=\"avia_11_2\" class=\"select \" id=\"avia_11_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_12_2'><label for=\"avia_12_2\" class=\"textare_label hidden textare_label_avia_12_2\">Any other information<\/label><textarea  name=\"avia_12_2\" class=\"text_area \" cols=\"40\" rows=\"7\" id=\"avia_12_2\" ><\/textarea><\/p><p class=\"hidden\"><input type=\"text\" name=\"avia_13_2\" class=\"hidden \" id=\"avia_13_2\" value=\"\" \/><\/p><p class='   form_element form_fullwidth' id='element_avia_14_2'><span class='value_verifier_label'>0 + 1 = ?<\/span><input name=\"avia_14_2_verifier\" type=\"hidden\" id=\"avia_14_2_verifier\" value=\"773412174\"\/><label for=\"avia_14_2\">Please prove that you are human by solving the equation <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><input name=\"avia_14_2\" class=\"text_input captcha\" type=\"text\" id=\"avia_14_2\" value=\"\"\/><\/p><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><\/form><div id=\"ajaxresponse_2\" class=\"ajaxresponse ajaxresponse_2 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-9  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><\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='av-layout-grid-2'  class='av-layout-grid-container av-2jft0b-35fca6f06f34b2d032652cbdb5fcd422 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class='flex_cell_inner'><\/div><\/div>\n<\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":4,"featured_media":0,"parent":2525,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-9336","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/tmckolkata.com\/in\/wp-json\/wp\/v2\/pages\/9336","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tmckolkata.com\/in\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/tmckolkata.com\/in\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/tmckolkata.com\/in\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/tmckolkata.com\/in\/wp-json\/wp\/v2\/comments?post=9336"}],"version-history":[{"count":0,"href":"https:\/\/tmckolkata.com\/in\/wp-json\/wp\/v2\/pages\/9336\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/tmckolkata.com\/in\/wp-json\/wp\/v2\/pages\/2525"}],"wp:attachment":[{"href":"https:\/\/tmckolkata.com\/in\/wp-json\/wp\/v2\/media?parent=9336"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}