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Registration Form ‘Rehabilitation in Breast Cancer’ 6 th and 7 th July 2013

4 th Annual two day workshop on Rehabilitation in Breast Cancer 06 th & 07 th July, 2013. Dear Friends,

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Registration Form ‘Rehabilitation in Breast Cancer’ 6 th and 7 th July 2013

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  1. 4thAnnual two day workshop on Rehabilitation in Breast Cancer 06th & 07th July, 2013 • Dear Friends, • Breast cancer is rapidly on the rise, more and more women are affected by it. This disease combats a lot of psychological and social issues regarding treatment, post operative management, care of the arm, prevention of edema and activities of daily living. Misconceptions about these can lead to serious complications. • To target these we are conducting a two day workshop on ‘Rehabilitation in Breast Cancer’ for Doctors, Physiotherapists & Nurses. • We believe the workshop will generate constructive ideas that could be translated into practice. • To allow a better interaction, we will be registering only 30 candidates. • Salient Features: • Lectures by eminent oncologists • Comprehensive acute post operative care • Chronic Issues • Lymphedema management by internationally certified therapist  • Practical training • Kindly fill the attached registration form. • Last Date for Registration:30th June, 2013. Registration Form ‘Rehabilitation in Breast Cancer’ 6th and 7th July 2013 Tata Memorial Hospital (PLEASE FILL THE FORM IN CAPITAL LETTERS)  Name: ____________________________________ Mailing Address: ____________________________ ________________________________________________________________________________________________________________________________________________________________________City:_________________Pincode:______________ E-Mail Address:_____________________________ Phone:):_______________Mobile:______________ Registration charges: -- Early Registration- Rs 1500/- (up to 20th June 2013) Late Registration- Rs 2000/- Mode of Payment: Cash/DD (In favor of ‘Tata Memorial Hospital’ payable at Mumbai)  DD No: ________________Dated: __________Bank Name:_________________ (Kindly write your name at the backside of the Demand Draft) Mail to: Dr (Mrs) AnuradhaDaptardar O-I-C, Physiotherapy, Room No: 55, Ground Flr, Main Bldg, Tata Memorial Hospital, Dr . E Borges Road, Parel, Mumbai-400012. For more registration forms, photocopy this form or send an email to aadaptardar@yahoo.com, vinsu24@yahoo.com, ajeetahasabnis@yahoo.co.in For queries Phone: 022 24177226 Organized by Physiotherapy Department Tata Memorial Hospital Venue: HBB Auditorium (13th floor) Tata Memorial Hospital

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