1. Hernia Essentials Diploma Registration form
Name : ______________________________
Country : ______________________________
Institution : ______________________________
Contact number : ______________________________
address : ______________________________
APHS Membership No. : ______________________________
Congress Registration No. : ______________________________
Hernia Essentials courses details :
Hernia Essentials Basics
Date : Place :
Hernia Essentials Practicals
Date : Place :
Hernia Essentials Fellowship
Date : _______ to _________
Institute :
APHS 2019 at Bali, Indonesia