117° CONGRESSO SPLLOT

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

Domenico Aloj

Event Timing

09/09/2021 - 10/09/2021

Event Location

Teatro Civico

Address

, Vercelli (Vercelli)