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REGISTRATION FORM
| Name |
: |
_______________________________________________________________ |
| Designation |
: |
_______________________________________________________________ |
| Company Address |
: |
_______________________________________________________________ |
| |
|
_______________________________________________________________ |
|
Postal Code : |
________________________ |
Country: |
________________________ |
Phone: |
________________________ |
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Fax: |
________________________ |
Email: |
________________________ |
Url: |
________________________ |
Product Category Nos :______________________
( Please select not more than Two Categories from the list
given below )
| |
Sr. No. |
Categories |
Products |
| |
1 |
Raw
materials/Sub-assemblies |
Plastics, Ceramics, Fabrics, Adhesives, Moulded Parts, Non-Wovens,
Additives, Silicon, other materials...More |
| |
2 |
Manufacturing Equipments and Technology for Medical Devices |
Medical
Devices Manufacturing, Plastics Processing machinery, Testing
Equipments, Packaging Machineries, etc...More |
| |
3 |
Components/Sub-assemblies for Medical devices |
Plastics
Molded Components, Tubing, Medical Bags & Pouches, Balloons, Guidewires,
Introducers...More |
| |
4 |
Packaging and Printing |
Packaging Equipment, Packaging Materials, Sterilization Equipment,
Labeling Equipment, Materials, etc...More |
| |
5 |
Processing and Treatments |
Coating,
Drilling, Bonding, Compounding, Labeling, Filtration, Moulding,
Assembly, Surface treatment, Tip-forming, etc...More |
| |
6 |
Fabrics |
Clothing/shoes, Linen, Laundry, Service, etc...More |
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7 |
Services
for Manufacturing of Medical Devices |
Analysis
Contract, Manufacturing, Market research, Testing, Sterilisation,
etc...More |
| |
8 |
Publications and other Services |
Publication, Consulting Services, Professional Institutions, Test
Agencies/ Certification Authorities, etc...More |
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9 |
Information and Communication Technology |
Documentation Services, Data Processing , Services and Equipments,
Software For Laboratories, Software For Surgeries, Telemedicine,
etc...More |
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10 |
Facility
Management |
Building
administration and supplies management / Building technical management /
Operation and Management of health facilities / Transport systems...More |
| |
11 |
Laboratory Equipment |
Agitators / Analyser appliances / Centrifuges / Cleaning equipment /
drying equipment...More |
| |
12 |
Premises
and Building Technology |
Building
components / Floor coverings, wall and ceiling systems / Technical
equipment management...More |
|
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Products/Services offered:
|
Advertising Tariff
(B&W) |
|
Print Area |
Print Size |
Rate |
|
Indian Rupees |
US$ |
EURO |
|
Full Page (4 Colour) |
25.00 x 19.00 cm. |
11000/- |
280 |
215 |
|
Full Page
(B/W) |
25.00 x 19.00 cm. |
7000/- |
185 |
145 |
|
Half Page (4 Colour) |
12.50 x 19.00 cm. |
7000/- |
200 |
180 |
|
Half Page (B/W) |
12.50 x 19.00 cm. |
4000/- |
115 |
90 |
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Quarter Page (B/W) |
12.50 x 09.50 cm. |
2500/- |
80 |
65 |
|
Bold Listing |
- |
1000/- |
40 |
35 |
Mode Of Payment:
International : please write to
b2b2008@medisourceasia.com
for more details regarding payment transfer.
India :
DD No :
Bank :
Branch :
Date :
Amount :
( Demand Draft in favour of “Classic Computer Services” payable at
Ahmedabad. )
Contact:
medisourceasia.com
B-4, Mandir Apts., Opp. P&T Colony, Nr. Jodhpur Char Rasta, Ahmedabad-380
015
Gujarat, India . Ph: +91-79-26740611 Telefax: +91-79-26754867, E-mail:
b2b2008@medisourceasia.com
| Details for Payment By Electronic
Transfer : |
|
Payment Transfer Advise To Be Given To Your Bank
(CURRENCY : US$)
Please Pay to, Citi Bank , New York , SWIFT CODE : CITIUS33 ( ABA
Number 021000089 ) a sum of USD _____ for further credit to Account
Number : 36152559 of Oriental Bank of Commerce, International
Banking Division, New Delhi ( SWIFT CODE : ORBCINBBIBD ) for
further credit to Account No. 10511010015730 of M/s "Classic Computer
Services" being maintained with Oriental Bank of Commerce, C.G. Road
Branch , Ahmedabad. ( SWIFT CODE : ORBCINBBAHM ) |
|
Payment Transfer Advise To Be Given To Your Bank ( CURRENCY :
EURO) Please Pay to, CITI BANK , NEW YORK,
SWIFT CODE : CITIUS33 a sum of EURO ____ for further credit to
ACCOUNT NUMBER: 0530553341 of Oriental Bank of Commerce,
INTERNATIONAL BANKING DIVISION, NEW DELHI (SWIFT CODE : ORBCINBBIB)
for further credit to Account No. 10511010015730 of M/s "Classic
Computer Services" being maintained with Oriental Bank of Commerce, C.G.
Road Branch, Ahmedabad, India.”. (SWIFT CODE : ORBCINBBAHM) |
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