122° CONGRESSO S.P.L.L.O.T.

1.Personal Data

Last Name*

First Name*

Date of Birth

Place of Birth

Address*

N.*

City*

Postal Code*

Province*

Telephone Number

Mobile Number*

E-mail*

Institute/Hospital

Occupation

Discipline

2.Invoice Data

3.Type of registration

4.Additional Services

5.Hotel Accommodation

Event President

Marco Bigoni

Event Timing

18/09/2026 - 18/09/2026

Event Location

Policlinico San Pietro

Address

Via Carlo Forlanini, 15, Ponte San Pietro