PHYSICON 2026 Registration
Registration Form
Personal Details
Fill all required fields
Full Name
*
Email
*
Mobile Number
*
Gender
*
Select gender
Male
Female
Other
City
*
State
*
Institute
*
Designation
*
Medical Council Number
Medical Council State
Registration Type
*
Choose member category
Non Member
Applicable for non-PSI participants.
PSI Member
Applicable for PSI members with member fee.
Participant Category
*
Early Bird fee applied by default
Category
Faculty / Consultant / SR
PG students (MD / PhD)
UG students (MBBS / MSc)
Foreign Faculty
Gala Dinner
*
Select whether you will attend the gala dinner
No
I will not attend the gala dinner
Yes
Add gala dinner charges
Accompanying Person
*
Select accompanying person option
None
No accompanying person
One
Add one accompanying person
Two
Add two accompanying persons
Accompanying Person 1 Name
Accompanying Person 1 Gala Dinner
No
Yes
Accompanying Person 2 Name
Accompanying Person 2 Gala Dinner
No
Yes
Payable Amount
Calculated from selected options
₹ 0
Select member type, phase, and category.
Selected Fee
₹ 0
Base Registration Fee
₹ 0
18% GST
₹ 0
2.36% Internet Handling Charges
₹ 0
Member Type
Non Member
Category
Faculty / Consultant / SR
Total Payable Amount
₹ 0
Reset
Submit Registration