75^th IPC

Indian Pharmaceutical Congress

ORDER FORM

SPONSORSHIP

Pharma Vision 2030
Global Leader in Indian Pharma Industry

To,

The Chairman - LOC

75^th Indian Pharmaceutical Congress, 2026

F-2, Shopping Complex, A-Block

Meera Bagh, New Delhi-110087

Dear Sir,

Please find enclosed a Cheque / Demand Draft / RTGS / NEFT details in favour of "75th IPC a/c IPGA" payable at New Delhi.

Cheque / DD / Reference No.*

Instrument number/Ref number enter karein.

Dated*

Kripya date select karein.

Amount (Rs.)*

₹

Valid amount enter karein.

Rupees (In words)*

Amount ko shabdon (words) mein likhein.

Drawn on (Name of the Bank)*

Bank ka naam enter karein.

Towards Sponsorship for*

Sponsorship category enter karein.

Name & Address of the Sponsorer with contact details

Name*

Apna naam enter karein.

Designation*

Apna pad (Designation) enter karein.

Name & Address of the Organisation / Company*

Company ka naam aur pata likhein.

Pin Code*

6-digit valid pincode enter karein.

Phone (Office)

Fax

Mobile Number*

+91

Valid 10-digit mobile number enter karein.

E-mail Address*

Valid email id enter karein.

Website

Encl : (Please mark ✓)

1. Email

Hardcopy

2. Cheque

Demand Draft

3. RTGS / NEFT

Bank Details for RTGS/NEFT

HDFC BANK

Favouring: "75th IPC a/c IPGA"
A/c No.: 50100243091802

IFSC: HDFC0004364
Branch: Dwarka, Sector-10, New Delhi-110075

(All Donations/Contribution are exempted under Section 80 (G) of Income Tax Act.)

For further details, please contact:

B. R. Sikri

Chairman - LOC

9810333492

sikribr@absmerc.com

Dr. Ajay Sachan

Chairman - Finance Committee

9811894990

drajaysachan@yahoo.co.in