Emara's Toxicological award Registration Form

January 21, 2012 ____________________________________ Name (Last, First, MI) ____________________________________ Organization ____________________________________ Address _________________________________________________________________________ ____________________ Born in Email For more information about the award, please contact Ashraf M. Emara, M.D., Professor Forensic Medicine and clinical Toxicology department Faculty of medicine Tanta University Mostafa7005605@yahoo.com