Personal Details

    Application No.

    Date

    Free Seat/ Payment Seat/ NRI/ Foreigen Student

    Category :
    GeneralOBCSCST

    Need Hostel Accommodation :
    YESNo

    Domicile of M.P.
    YESNo

    Course Name
    ANMGNMBSCP. BSC

    First Name

    Middle Name

    Surname

    Date of Birth

    Age

    Sex
    MaleFemale

    Married
    YESNo

    Correspondence Address

    Telephone No. (with STD Code)

    Permanent Address

    Telephone No. (with STD Code)

    Father’s Name :

    Occupation :

    Organisation :

    Address :

    Telephone No. (with STD Code)

    Total Annual Income

    Name of Local Guardian :

    Address :

    Telephone No. (with STD Code)

    Academic Performance : ( From Class X)

    Course Completed :
    Board / University :
    Year of Passing :
    Marks obtained :
    Percentage :

    Academic Performance : ( From Class XII)

    Course Completed :
    Board / University :
    Year of Passing :
    Marks obtained :
    Percentage :

    place :

    Upload Documents

    (1)High School MarkSheet
    (2)Intermediate Marksheet
    (3)Domicile Certificate
    (4)Aadhaar Card
    (5)Samgra I’d
    (6)Photo
    (7)Income Proof
    (8)Cast Certificate
    (9)Transfer Certificate
    (10)Character Certificate
    (11)Sport Certificate