(A Deemed University Under Sec.(3) of UGC Act, 1956)


PLEASE FILL THIS FORM BEFORE DOWN LOADING THE APPLICATION FORM

Course:(Select)
Entrance Exam Centre:(Select)
Name of the Candidate:
Father's Name:
Date of Birth: Date:(DD) Month:(MM) Year:(YYYY)
House No./Name:
Locality:
District/State:
Pin Code:
Mobile No. (10 Digit):
Aggregate Percentage of marks in MBBS/BDS:
No. of Attempts for MBBS/BDS:
Father's PAN card No.:
Mother's PAN card No.: