Registration Form

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4th Sports Imaging Seminar
MR Imaging of Knee Injuries
18 April 2015 (Saturday)
12.00 noon to 5.00 pm
Tower B, Learning Centre – Auditorium
Khoo Teck Puat Hospital
90 Yishun Central Singapore 768828
Registration Form
Name
MCR no.
Contact no.
Email
Clinic/Hospital
name
Clinic/Hospital
Address
Postal Code
Phone no.
Fax no.
Registration Fees
Cheque Payable
to
Mail Cheque to
(write your name and
MCR behind the
cheque)
$ 53.50 per pax ( inclusive of GST)
Includes Lunch & Tea break
Alexandrahealth Pte Ltd
Attention : Rabiya Kassim
Dept of Diagnostic Radiology
Khoo Teck Puat Hospital
90 Yishun Central
Singapore 768828
Kindly RSVP by 9 April 2015 (Thursday) to Ms Rabiya Bte Mohd Kassim
Tel: 6602 2689 or Email: kassim.rabiya@alexandrahealth.com.sg
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